Lee Jusung, Pathak Prabhat, Panday Siddhartha Bikram, Moon Jeheon
Department of Sport Science, Kangwon National University, Chuncheon, Republic of Korea.
Department of Physical Education, Seoul National University, Seoul, Republic of Korea.
Orthop J Sports Med. 2020 Nov 19;8(11):2325967120963180. doi: 10.1177/2325967120963180. eCollection 2020 Nov.
Although there is a higher prevalence of noncontact anterior cruciate ligament (ACL) injuries during a direction diversion maneuver (DDM), no previous studies have reported how foot-planting strategies affect ACL loading.
To investigate the effect of foot-planting strategies on ACL loading in women during a DDM task using a musculoskeletal modeling approach.
Descriptive laboratory study.
A total of 13 female participants performed a DDM task, which involved running at 4.5 ± 0.2 m/s and turning left at 35° to 55° under a foot-planting strategy in 3 directions: neutral, toe-in, and toe-out. Kinematic and kinetic data were measured with the use of a 3-dimensional motion capture system and force platform to calculate variables such as joint angle, shear force, and moment. Anterior ACL and posterior ACL forces were extracted using musculoskeletal modeling.
The peak anterior ACL force was significantly larger for the toe-out condition (31.29 ± 4.02 N/body weight [BW]) compared with the toe-in condition (25.43 ± 5.68 N/BW) ( = .047), with no significant difference in the neutral condition. The toe-out condition had a higher knee valgus angle (2.98° ± 4.20°; = .041), knee shear force (10.20 ± 1.69 N/BW; = .009), and knee internal rotation moment (-0.18 ± 0.16 N·m/BW×height; = .012) than the toe-in and neutral conditions.
Through musculoskeletal modeling, we were able to conclude that the toe-out condition during the DDM might result in a higher risk of ACL injuries. Athletes and sports practitioners should avoid the toe-out foot-planting strategy when participating in a sporting activity.
Based on these findings, medical professionals and athletic coaches can gain knowledge on how foot-planting strategy affects ACL loading. Understanding the actual cause of an ACL injury can be useful for designing preventive training programs or strategies to decrease the risk of such injuries.
尽管在变向动作（DDM）中，非接触性前交叉韧带（ACL）损伤的发生率较高，但此前尚无研究报道足部着地策略如何影响ACL负荷。
采用肌肉骨骼建模方法，研究女性在DDM任务中足部着地策略对ACL负荷的影响。
描述性实验室研究。
共有13名女性参与者完成一项DDM任务，包括以4.5±0.2米/秒的速度跑步，并在三种足部着地策略下向左转35°至55°，这三种策略分别为：中立、内扣和外展。使用三维运动捕捉系统和测力平台测量运动学和动力学数据，以计算关节角度、剪切力和力矩等变量。通过肌肉骨骼建模提取前交叉韧带和后交叉韧带的力。
与内扣状态（25.43±5.68牛/体重[BW]）相比，外展状态下的前交叉韧带峰值力显著更大（31.29±4.02牛/体重）（P = 0.047），中立状态下无显著差异。外展状态下的膝关节外翻角度（2.98°±4.20°；P = 0.041）、膝关节剪切力（10.20±1.69牛/体重；P = 0.009）和膝关节内旋力矩（-0.18±0.16牛·米/体重×身高；P = 0.012）均高于内扣和中立状态。
通过肌肉骨骼建模，我们能够得出结论，DDM过程中的外展状态可能会导致ACL损伤风险更高。运动员和体育从业者在参加体育活动时应避免外展足部着地策略。
基于这些发现，医学专业人员和体育教练可以了解足部着地策略如何影响ACL负荷。了解ACL损伤的实际原因有助于设计预防训练计划或策略，以降低此类损伤的风险。
