Sports Medicine Biodynamics Center

Medicine, United States

Sports Medicine Biodynamics Center

Medicine, United States
SEARCH FILTERS
Time filter
Source Type

Myer G.D.,Cincinnati Childrens Hospital Medical Center | Myer G.D.,Sports Medicine Biodynamics Center | Myer G.D.,Rocky Mountain University of Health Professions | Ford K.R.,Cincinnati Childrens Hospital Medical Center | And 6 more authors.
American Journal of Sports Medicine | Year: 2010

Background: Prospective measures of high knee abduction moment (KAM) during landing identify female athletes at high risk for anterior cruciate ligament injury. Laboratory-based measurements demonstrate 90% accuracy in prediction of high KAM. Clinic-based prediction algorithms that employ correlates derived from laboratory-based measurements also demonstrate high accuracy for prediction of high KAM mechanics during landing. Hypotheses: Clinic-based measures derived from highly predictive laboratory-based models are valid for the accurate prediction of high KAM status, and simultaneous measurements using laboratory-based and clinic-based techniques highly correlate. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: One hundred female athletes (basketball, soccer, volleyball players) were tested using laboratory-based measures to confirm the validity of identified laboratory-based correlate variables to clinic-based measures included in a prediction algorithm to determine high KAM status. To analyze selected clinic-based surrogate predictors, another cohort of 20 female athletes was simultaneously tested with both clinic-based and laboratory-based measures. Results: The prediction model (odds ratio: 95% confidence interval), derived from laboratory-based surrogates including (1) knee valgus motion (1.59: 1.17-2.16 cm), (2) knee flexion range of motion (0.94: 0.89°-1.00°), (3) body mass (0.98: 0.94-1.03 kg), (4) tibia length (1.55: 1.20-2.07 cm), and (5) quadriceps-to-hamstrings ratio (1.70: 0.48%-6.0%), predicted high KAM status with 84% sensitivity and 67% specificity (P <.001). Clinic-based techniques that used a calibrated physician's scale, a standard measuring tape, standard camcorder, ImageJ software, and an isokinetic dynamometer showed high correlation (knee valgus motion, r =.87; knee flexion range of motion, r =.95; and tibia length, r =.98) to simultaneous laboratory-based measurements. Body mass and quadriceps-to-hamstrings ratio were included in both methodologies and therefore had r values of 1.0. Conclusion: Clinically obtainable measures of increased knee valgus, knee flexion range of motion, body mass, tibia length, and quadriceps-to-hamstrings ratio predict high KAM status in female athletes with high sensitivity and specificity. Female athletes who demonstrate high KAM landing mechanics are at increased risk for anterior cruciate ligament injury and are more likely to benefit from neuromuscular training targeted to this risk factor. Use of the developed clinic-based assessment tool may facilitate high-risk athletes' entry into appropriate interventions that will have greater potential to reduce their injury risk. © The Author(s), 2010.


Faigenbaum A.D.,The College of New Jersey | Myer G.D.,Cincinnati Childrens Hospital Medical Center | Myer G.D.,Sports Medicine Biodynamics Center | Myer G.D.,Rocky Mountain University of Health Professions
British Journal of Sports Medicine | Year: 2010

A literature review was employed to evaluate the current epidemiology of injury related to the safety and efficacy of youth resistance training. Several case study reports and retrospective questionnaires regarding resistance exercise and the competitive sports of weightlifting and powerlifting reveal that injuries have occurred in young lifters, although a majority can be classified as accidental. Lack of qualified instruction that underlies poor exercise technique and inappropriate training loads could explain, at least partly, some of the reported injuries. Current research indicates that resistance training can be a safe, effective and worthwhile activity for children and adolescents provided that qualified professionals supervise all training sessions and provide age-appropriate instruction on proper lifting procedures and safe training guidelines. Regular participation in a multifaceted resistance training programme that begins during the preseason and includes instruction on movement biomechanics may reduce the risk of sports-related injuries in young athletes. Strategies for enhancing the safety of youth resistance training are discussed.


Paterno M.V.,Cincinnati Childrens Hospital Medical Center | Paterno M.V.,Sports Medicine Biodynamics Center | Paterno M.V.,University of Cincinnati | Paterno M.V.,Health Science University | And 15 more authors.
American Journal of Sports Medicine | Year: 2010

Background: Athletes who return to sport participation after anterior cruciate ligament reconstruction (ACLR) have a higher risk of a second anterior cruciate ligament injury (either reinjury or contralateral injury) compared with non-anterior cruciate ligament- injured athletes. Hypotheses: Prospective measures of neuromuscular control and postural stability after ACLR will predict relative increased risk for a second anterior cruciate ligament injury. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: Fifty-six athletes underwent a prospective biomechanical screening after ACLR using 3-dimensional motion analysis during a drop vertical jump maneuver and postural stability assessment before return to pivoting and cutting sports. After the initial test session, each subject was followed for 12 months for occurrence of a second anterior cruciate ligament injury. Lower extremity joint kinematics, kinetics, and postural stability were assessed and analyzed. Analysis of variance and logistic regression were used to identify predictors of a second anterior cruciate ligament injury. Results: Thirteen athletes suffered a subsequent second anterior cruciate ligament injury. Transverse plane hip kinetics and frontal plane knee kinematics during landing, sagittal plane knee moments at landing, and deficits in postural stability predicted a second injury in this population (C statistic = 0.94) with excellent sensitivity (0.92) and specificity (0.88). Specific predictive parameters included an increase in total frontal plane (valgus) movement, greater asymmetry in internal knee extensor moment at initial contact, and a deficit in single-leg postural stability of the involved limb, as measured by the Biodex stability system. Hip rotation moment independently predicted second anterior cruciate ligament injury (C = 0.81) with high sensitivity (0.77) and specificity (0.81). Conclusion: Altered neuromuscular control of the hip and knee during a dynamic landing task and postural stability deficits after ACLR are predictors of a second anterior cruciate ligament injury after an athlete is released to return to sport. © The Author(s), 2010.


Faigenbaum A.D.,The College of New Jersey | Myer G.D.,Cincinnati Childrens Hospital Medical Center | Myer G.D.,Sports Medicine Biodynamics Center | Myer G.D.,Rocky Mountain University of Health Professions
Current Sports Medicine Reports | Year: 2010

A growing number of children and adolescents are involved in resistance training in schools, fitness centers, and sports training facilities. In addition to increasing muscular strength and power, regular participation in a pediatric resistance training program may have a favorable influence on body composition, bone health, and reduction of sports-related injuries. Resistance training targeted to improve low fitness levels, poor trunk strength, and deficits in movement mechanics can offer observable health and fitness benefits to young athletes. However, pediatric resistance training programs need to be well-designed and supervised by qualified professionals who understand the physical and psychosocial uniqueness of children and adolescents. The sensible integration of different training methods along with the periodic manipulation of programs design variables over time will keep the training stimulus effective, challenging, and enjoyable for the participants. Copyright © 2010 by the American College of Sports Medicine.


Sugimoto D.,Micheli Center for Sports Injury Prevention | Sugimoto D.,Boston Childrens Hospital | Sugimoto D.,Cincinnati Childrens Hospital Medical Center | Sugimoto D.,Sports Medicine Biodynamics Center | And 12 more authors.
British Journal of Sports Medicine | Year: 2015

Context: Clinical trials have demonstrated that preventive neuromuscular training (PNMT) can be effective to reduce ACL injuries in young females. However, the magnitude of the overall effect of PNMT for ACL injury reduction has not reached consensus. In addition, the effects of individual exercises in PNMT that optimise ACL injury reduction are unknown. Objective: The purpose of this project was to systematically review previously published clinical trials and evaluate types of exercises that best support ACL injury reduction in young females. Data sources: The key words 'knee', 'anterior cruciate ligament', 'ACL', 'prospective', 'neuromuscular', 'training', 'female', and 'prevention' were used for studies published from 1995 to May 2012 in PubMed and EBSCO host. Study selection: Inclusion criteria for the current analysis were: (1) documented number of ACL injuries, (2) employed a PNMT intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective controlled study design, (5) recruited female athletes and (6) recorded exercises implemented in the PNMT. Data extraction: The number of ACL injuries and female athletes in each group (control and intervention) were extracted. In addition, exercises were categorised into four types and analysed for each investigation. Data synthesis: A total of 14 clinical trials met the inclusion criteria. The subgroup analyses identified fewer ACL injuries in PNMT that focused on strengthening (OR 0.32, 95% CI 0.23 to 0.46, p=0.001), proximal control exercises (OR 0.33, 95% CI 0.23 to 0.47, p=0.001) and multiple exercise interventions (OR 0.32, CI 0.22 to 0.46, p=0.001). Conclusions: The current subgroup analyses indicate strengthening, proximal control exercises and multi exercise genres increased efficacy in PNMT intervention designed to reduce ACL injury in young female athletes.


Zwolski C.,Cincinnati Childrens Hospital | Zwolski C.,Sports Medicine Biodynamics Center | Schmitt L.C.,Cincinnati Childrens Hospital | Schmitt L.C.,Sports Medicine Biodynamics Center | And 11 more authors.
American Journal of Sports Medicine | Year: 2016

Background: The incidence of contralateral anterior cruciate ligament (ACL) injury after ACL reconstruction (ACLR) is high. Often, return-to-sport (RTS) tests of strength and functional hopping rely on limb symmetry indices (LSIs) to identify deficits, although the utility of these measures in athletes with bilateral ACL injuries is unknown. Purpose/Hypothesis: The aim of this study was to investigate if LSIs used as RTS criteria in female patients after unilateral ACLR were appropriate for female patients with bilateral ACL involvement. The hypothesis tested was that asymmetries with traditional LSI measures would be present in a population after unilateral ACLR but would not be present in a population with bilateral ACLR due to the lack of a healthy internal control limb. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 45 female subjects were classified into 3 groups: after second (contralateral) ACLR (ACLR-B; n = 15); after primary unilateral ACLR (ACLR-U; n = 15); and uninjured controls (CTRL; n = 15). After being cleared for RTS, each subject completed a single-legged hop for distance (SLHD), triple hop for distance (THD), and triple-crossover hop for distance (CHD) test, in addition to an isometric quadriceps strength test on both limbs. Means and LSI ([involved limb/uninvolved limb] × 100) were calculated for each test. Limb symmetry deficits were defined by LSI <90%. Results: Analysis of functional hop testing revealed a side × group interaction for SLHD (P =.001), THD (P =.019), and CHD (P =.04). Side-to-side differences were found in the ACLR-U group for all hop tests (P =.001-.003) and in the ACLR-B group for SLHD (P =.002) and THD tests (P =.024). No side-to side differences were seen in the CTRL group (P >.05). A side × group interaction was found for isometric quadriceps strength (P =.006), with lower LSI seen in the ACLR-U group (81% ± 17.6%) compared with the CTRL group (102.2% ± 10.8%) and the ACLR-B group (95.6% ± 24.9%). Although no interaction was seen, side-to-side differences were noted in the THD in the ACLR-U group (P =.013) and ACLR-B group (P =.024) and in the CHD in the ACLR-U group (P =.001). Despite absence of an LSI deficit, bilateral peak quadriceps strength in the ACLR-B group was comparable to the involved limb of the ACLR-U group and less than in the CTRL group (P =.012). Conclusion: Both the ACLR-U and the ACLR-B groups demonstrated side-to-side deficits during functional hop tests; however, these deficits were not identified according to the clinically accepted LSI values of ≥90%, calling into question the efficacy of current RTS criteria. At the time of RTS, only individuals in the ACLR-U group demonstrated an altered LSI in quadriceps strength. Significantly lower quadriceps strength of both limbs in the ACLR-B group was seen compared with the CTRL group, despite no LSI deficits in quadriceps strength. Current use of LSIs during strength and performance tests may not be an appropriate means of identifying residual deficits in female patients after bilateral ACLR at time of RTS. Furthermore, a better indicator of strength performance in this population may need to include a comparison of strength performance values to the normative values of healthy controls. © American Orthopaedic Society for Sports Medicine.


Myer G.D.,Cincinnati Childrens Hospital Medical Center | Myer G.D.,Sports Medicine Biodynamics Center | Myer G.D.,Rocky Mountain University of Health Professions | Ford K.R.,Cincinnati Childrens Hospital Medical Center | And 7 more authors.
Clinical Biomechanics | Year: 2010

Background: Prospective measures of high knee abduction moment during landing identify female athletes at high risk for non-contact anterior cruciate ligament injury. Biomechanical laboratory measurements predict high knee abduction moment landing mechanics with high sensitivity (85%) and specificity (93%). The purpose of this study was to identify correlates to laboratory-based predictors of high knee abduction moment for use in a clinic-based anterior cruciate ligament injury risk prediction algorithm. The hypothesis was that clinically obtainable correlates derived from the highly predictive laboratory-based models would demonstrate high accuracy to determine high knee abduction moment status. Methods: Female basketball and soccer players (N = 744) were tested for anthropometrics, strength and landing biomechanics. Pearson correlation was used to identify clinically feasible correlates and logistic regression to obtain optimal models for high knee abduction moment prediction. Findings: Clinical correlates to laboratory-based measures were identified and predicted high knee abduction moment status with 73% sensitivity and 70% specificity. The clinic-based prediction algorithm, including (Odds Ratio: 95% confidence interval) knee valgus motion (1.43:1.30-1.59 cm), knee flexion range of motion (0.98:0.96-1.01°), body mass (1.04:1.02-1.06 kg), tibia length (1.38:1.25-1.52 cm) and quadriceps to hamstring ratio (1.70:1.06-2.70) predicted high knee abduction moment status with C statistic 0.81. Interpretation: The combined correlates of increased knee valgus motion, knee flexion range of motion, body mass, tibia length and quadriceps to hamstrings ratio predict high knee abduction moment status in female athletes with high sensitivity and specificity. Clinical Relevance: Utilization of clinically obtainable correlates with the prediction algorithm facilitates high non-contact anterior cruciate ligament injury risk athletes' entry into appropriate interventions with the greatest potential to prevent injury. © 2010 Elsevier Ltd. All rights reserved.


Myer G.D.,Cincinnati Childrens Hospital Medical Center | Myer G.D.,Sports Medicine Biodynamics Center | Myer G.D.,Rocky Mountain University of Health Professions | Myer G.D.,Ohio State University | And 8 more authors.
Physician and Sportsmedicine | Year: 2011

Aims: Prospective measures of high knee abduction moment (KAM) during landing identify female athletes at increased risk for anterior cruciate ligament (ACL) injury. Laboratory-driven measurements predict high KAM with 90% accuracy. This study aimed to validate the clinic-based variables against 3-dimensional motion analysis measurements. Methods: Twenty female basketball, soccer, and volleyball players (age, 15.9 ± 1.3 years; height, 163.6 ± 9.9 cm; body mass, 57.0 ± 12.1 kg) were tested using 3-dimensional motion analysis and clinic-based techniques simultaneously. Multiple logistic regression models have been developed to predict high KAM (a surrogate for ACL injury risk) using both measurement techniques. Clinic-based measurements were validated against 3-dimensional motion analysis measures, which were recorded simultaneously, using within- and between-method reliability as well as sensitivity and specificity comparisons. Results: The within-variable analysis showed excellent inter-rater reliability for all variables using both 3-dimensional motion analysis and clinic-based methods, with intraclass correlation coefficients (ICCs) that ranged from moderate to high (0.60-0.97). In addition, moderate-to-high agreement was observed between 3-dimensional motion analysis and clinic-based measures, with ICCs ranging from 0.66 to 0.99. Bland-Altman plots confirmed that each variable provided no systematic shift between 3-dimensional motion analysis and clinic-based methods, and there was no association between difference and average. A developed regression equation also supported model validity with > 75% prediction accuracy of high KAM using both the 3-dimensional motion analysis and clinic-based techniques. Conclusion: The current validation provides the critical next step to merge the gap between laboratory identification of injury risk factors and clinical practice. Implementation of the developed prediction tool to identify female athletes with high KAM may facilitate the entry of female athletes with high ACL injury risk into appropriate injury-prevention programs. © The Physician and Sportsmedicine.


Myer G.D.,Cincinnati Childrens Hospital | Myer G.D.,Sports Medicine Biodynamics Center | Myer G.D.,Rocky Mountain University of Health Professions | Ford K.R.,Cincinnati Childrens Hospital | And 6 more authors.
British Journal of Sports Medicine | Year: 2011

Background: High knee abduction moment (KAM) landing mechanics, measured in the biomechanics laboratory, can successfully identify female athletes at increased risk for anterior cruciate ligament (ACL) injury. Methods: The authors validated a simpler, clinic-based ACL injury prediction algorithm to identify female athletes with high KAM measures. The validated ACL injury prediction algorithm employs the clinically obtainable measures of knee valgus motion, knee flexion range of motion, body mass, tibia length and quadriceps-tohamstrings ratio. It predicts high KAMs in female athletes with high sensitivity (77%) and specificity (71%). Conclusion: This report outlines the techniques for this ACL injury prediction algorithm using clinic-based measurements and computer analyses that require only freely available public domain software.


Barber Foss K.D.,Cincinnati Childrens Hospital Medical Center | Barber Foss K.D.,Sports Medicine Biodynamics Center | Barber Foss K.D.,College of Mount St. Joseph | Myer G.D.,Sports Medicine Biodynamics Center | And 9 more authors.
Journal of Athletic Training | Year: 2012

Context: Anterior knee pain is a common disorder in female athletes with an undefined cause. The relative prevalence of specific patellofemoral disorders associated with anterior knee pain in adolescent females remains undetermined. Objective: To determine the prevalence of specific patellofemoral disorders obtained using the differential diagnosis of anterior knee pain in adolescent female athletes during preparticipation screening. Design: Descriptive epidemiology study. Setting: Preparticipation screening evaluations at a county public school district in Kentucky. Patients or Other Participants: A total of 419 unique middle and high school-aged female athletes. Main Outcome Measure(s): Participants were evaluated by physicians for anterior knee pain over 3 consecutive basketball seasons. Given the longitudinal nature of this study, some participants were tested longitudinally over multiple years. Results: Over the course of 3 basketball seasons, 688 patient evaluations were performed. Of these, 183 (26.6%) were positive for anterior knee pain. A statistically significant difference was noted in the prevalence of anterior knee pain by school level, with 34.4% (n = 67) in high school-aged athletes versus 23.5% (n=116) in middle school-aged athletes (P < .05). In the 1376 knees evaluated, patellofemoral dysfunction was the most common diagnosis, with an overall prevalence of 7.3% (n = 100). The only diagnosis shown to be statistically different between age levels was Sinding-Larsen-Johansson disease or patellar tendinopathy, with 38 cases (9.7%) in high school-aged and 31 (3.1%) in middle school-aged athletes (P < .05). Conclusions: Anterior knee pain was present in 26.6% of the adolescent female athletes screened over 3 years. Symptoms of anterior knee pain likely persist after middle school-aged onset and reach peak prevalence during the high school years. © by the National Athletic Trainers' Association, Inc.

Loading Sports Medicine Biodynamics Center collaborators
Loading Sports Medicine Biodynamics Center collaborators