Bedo Bruno Luiz Souza, Cesar Guilherme Manna, Moraes Renato, Mariano Fábio Pamplona, Vieira Luiz Henrique Palucci, Andrade Vitor Luiz, Santiago Paulo Roberto Pereira
University of Sao Paulo.
Madonna Rehabilitation Hospitals.
J Appl Biomech. 2021 Jun 1;37(3):188-195. doi: 10.1123/jab.2020-0141. Epub 2021 Feb 10.
Noncontact anterior cruciate ligament ruptures generally occur during unanticipated sidestep cutting maneuvers when athletes have their visual attention focused on the opponent. The authors investigated the influence of uncertainty related to the side to perform the sidestep cutting maneuver on knee kinematics of female handball athletes. A total of 31 female handball athletes performed the sidestep cutting maneuver during anticipated and uncertain conditions. During the uncertain condition, visual cues indicated the direction of the reactive sidestep cutting maneuver. Between-condition differences were compared using the Student t test for paired samples calculated with statistical parametric mapping. Lower knee flexion angle was detected during the uncertain condition compared with the anticipated condition for the nondominant limb (0%-8% of the sidestep cycle). Knee abduction was larger during the uncertain condition for both the dominant (15%-41% of the sidestep cycle) and nondominant (0%-18% of the sidestep cycle) limbs compared with the anticipated condition. The nondominant leg showed higher knee abduction (36%-68% of the sidestep cycle) during the uncertain condition compared with the anticipated condition. The athletes' approach velocity was slower during the uncertain condition. The uncertain condition impacted knee kinematics and potentially positioned the joint at greater risk of injury by decreasing the flexion angle in the nondominant leg and increasing the joint valgus bilaterally.
非接触性前交叉韧带断裂通常发生在运动员视觉注意力集中在对手身上时意外的侧向跨步变向动作中。作者研究了与执行侧向跨步变向动作的方向相关的不确定性对女子手球运动员膝关节运动学的影响。共有31名女子手球运动员在可预期和不可预期的条件下进行了侧向跨步变向动作。在不可预期的条件下，视觉线索指示了反应性侧向跨步变向动作的方向。使用基于统计参数映射计算的配对样本的Student t检验比较不同条件之间的差异。与可预期条件相比，在不可预期条件下，非优势肢体在侧向跨步周期的0%-8%期间检测到较低的膝关节屈曲角度。与可预期条件相比，在不可预期条件下，优势肢体（侧向跨步周期的15%-41%）和非优势肢体（侧向跨步周期的0%-18%）的膝关节外展均更大。与可预期条件相比，在不可预期条件下，非优势腿在侧向跨步周期的36%-68%期间表现出更高的膝关节外展。在不可预期条件下，运动员的接近速度较慢。不可预期条件影响膝关节运动学，并可能通过降低非优势腿的屈曲角度和双侧增加关节外翻，使关节处于更大的受伤风险中。
