Sports Med. 2014 Nov;44(11):1573-88. doi: 10.1007/s40279-014-0225-3.
Knee joint mechanics during sidestepping are associated with anterior cruciate ligament injury. Unplanned sidestepping more closely emulates game scenarios when compared with planned sidestepping by limiting decision time, increasing knee loading and challenging the integrity of soft-tissue structures in the knee. It is important to quantify the loads that may challenge the integrity of the knee during planned and unplanned sidestepping.
Our objective was to review literature on knee mechanics during planned and unplanned phases of sidestepping.
PubMed, CINAHL, MEDLINE (EBSCO), SPORTDiscus and Web of Science were searched using the terms knee mechanics OR knee kine*, AND plan*, unplan*, anticipat*, unanticipat*, side*, cut* or chang*.
A systematic approach was used to evaluate 4,629 records. Records were excluded when not available in English, only available in abstract of conference proceedings, not involving a change-of-direction sidestep, not comparing planned and unplanned or maintaining a running velocity greater than 2 m s(−1).
Included studies were evaluated independently by two authors using a custom-designed methodological quality assessment derived from the Physiotherapy Evidence Database (PEDro) scale and then confirmed by a third author.
Only six studies met the inclusion criteria and were retained for meta-analysis. Magnitude-based inferences were used to assess the standardised effect of the differences between planned and unplanned sidestepping. Knee angles and knee moments were extracted and reported for flexion/extension, abduction/adduction and internal/external rotation for initial contact, weight acceptance, peak push-off and final push-off phases of sidestepping.
For kinematic variables, unplanned sidestepping produced a wide range of small to large increases in knee extension angles, small and moderate increases in knee abduction angles and a small increase in internal rotation angle relative to planned sidestepping during the sidestepping manoeuvre. For kinetic variables, unplanned sidestepping produced mostly small (small to large) increases in knee flexor moments, small to moderate increases in knee abductor moments and mostly moderate (small to large) increases in internal rotator moments relative to planned sidestepping.
Approach velocity constraints during the sidestepping manoeuvre were lifted due to the low number of eligible studies. The varying approach velocities included (ranging from 3.0 to 5.5 m s(−1)) may impact the kinematic and kinetic variables examined in this review.
Differences in knee mechanics between planned and unplanned sidestepping exist. The most substantial effects occurred during the weight acceptance phase of sidestepping. It seems that biomechanical factors commonly associated with anterior cruciate ligament injury risk are affected the most during the loading phase compared with peak push-off; made evident in the coronal (abductor) and transverse (internal rotator) knee kinetic data presented in this review. The authors of this review propose a rationale for the incorporation of unplanned sport tasks in the development of anterior cruciate ligament injury screening and in prophylactic training programmes.
侧步时膝关节力学与前交叉韧带损伤有关。与计划侧步相比，非计划侧步通过限制决策时间、增加膝关节负荷并挑战膝关节内软组织结构的完整性，更能模拟比赛场景。重要的是要量化在计划和非计划侧步过程中可能对膝关节完整性造成挑战的负荷。
我们的目的是回顾关于侧步计划和非计划阶段膝关节力学的文献。
使用术语“膝关节力学”或“膝关节运动学”，以及“计划”、“非计划”、“预期”、“非预期”、“侧”、“切”或“变”，在 PubMed、CINAHL、MEDLINE（EBSCO）、SPORTDiscus 和 Web of Science 中进行了搜索。
使用一种系统的方法评估了 4629 条记录。当记录不是英文的、仅在会议论文摘要中提供的、不涉及变向侧步的、不比较计划和非计划的或保持跑步速度大于 2 m s(-1)的记录时，将其排除在外。
两名作者独立使用源自 Physiotherapy Evidence Database (PEDro) 量表的定制方法学质量评估来评估纳入的研究，并由第三名作者确认。
只有六项研究符合纳入标准并被保留进行荟萃分析。基于幅度的推论用于评估计划和非计划侧步之间差异的标准化效应。提取并报告了侧步初始接触、承重、峰值蹬离和最终蹬离阶段的膝关节角度和膝关节力矩，用于屈伸、外展/内收和内外旋转。
对于运动学变量，与计划侧步相比，非计划侧步在侧步过程中产生了大范围的小到大量的膝关节伸展角度增加、小到中度的膝关节外展角度增加和小的内旋角度增加。对于动力学变量，与计划侧步相比，非计划侧步主要产生小（小到大）的膝关节屈肌力矩增加、小到中度的膝关节外展力矩增加和主要为中度（小到大）的内旋力矩增加。
由于符合条件的研究数量较少，侧步过程中的接近速度限制被取消。包括的各种接近速度（范围为 3.0 至 5.5 m s(-1)) 可能会影响本综述中检查的运动学和动力学变量。
计划和非计划侧步之间的膝关节力学存在差异。在侧步的承重阶段，差异最大。似乎与前交叉韧带损伤风险相关的生物力学因素在加载阶段受到的影响最大，而不是在峰值蹬离阶段；在本综述中提出的冠状（外展）和横断（内旋）膝关节动力学数据中可以明显看出这一点。本综述的作者提出了将非计划运动任务纳入前交叉韧带损伤筛查和预防性训练计划的理由。
