- Email: [email protected]
Knee valgus alignment influences the energy absorption on the hip joint during a drop vertical jump
ee2
Abstracts / Physical Therapy in Sport 28 (2017) e1ee25
compare the resultant, anteroposterior, vertical, and mediolateral accelerations among the five most frequent movements that occurred during a game. Results: There were 1342 movements that generated >4 G. The top five movements were lunging during an underhand stroke with the dominant leg (264 cases, 1.52 (1.34 e 1.70) cases/min [mean (95%CI)]), landing after an overhand stroke on the non-dominant leg (164 cases, 0.94 (0.80 e 1.09) cases/min), landing after an overhand stroke on the dominant leg (161 cases, 0.93 (0.78 e 1.07) cases/min), cutting from a split step using the nondominant leg (123 cases, 0.71 (0.58 e 0.83) cases/min), and cutting from a split step using the dominant leg (118 cases, 0.68 (0.56 e 0.80) cases/min). The resultant acceleration of landing after an overhand stroke on the dominant leg was higher than that of other movements. The mediolateral acceleration of lunging during an underhand stroke with the dominant leg was higher than that of other movements. Conclusion: Landing on a single leg from an overhand stroke and lunging during an underhand stroke, which has been reported as a movement at risk for an anterior cruciate ligament injury (Kimura et al., 2010), occurred frequently with high acceleration. The accelerations were different among the five movements. Measuring trunk acceleration during actual competitive play could clarify the load and risk of injury. References Kimura, Y., et al., Br J Sports Med, 2010. 44(15): p. 1124-7. TIBIAL TUBEROSITY MATURATION COULD PREDICT THE OCCURRENCE OF OSGOOD-SCHLATTER’S DISEASE IN ADOLESCENT MALE FOOTBALL PLAYERS Naoki Akiyoshi 1, Yoshitomo Saita 2, Yohei Kobayashi 2, Keiji Kobayashi 2, Yu Kawamura 1, Hiroshi Ikeda 2. 1 Department of Rehabilitation, Oyumino Central Hospital, Japan; 2 Department of Orthopaedics and Sports Medicine, Juntendo University, School of Medicine, Japan Introduction and Aims: Osgood-Schlatter’s disease (OSD) is defined as an apophysitis of the anterior aspect of the tibial tuberosity (TT). Although TT maturation would be related to the occurrence of OSD, causal effect of TT maturation remains unclear. Therefore, we aimed to examine the relationship between the TT maturation and the incidence of OSD. Methods: Prospective analysis was conducted on 96 adolescent male football players (12.8±0.2 years old). Heel-buttock distance (HBD) was measured as a tightness of anterior thigh and ultrasonography (GE Healthcaare, LOGIQe) of TT were performed at the beginning of the season. The degree of TT maturation on ultrasonography was divided into 4 stages (stage1; cartilaginous stage, stage 2; apophyseal stage, stage 3; epiphyseal stage, stage 4; bony stage). We defined stage 1-2 as an immature stage, while stage 3-4 as a mature stage. The observed 96 players were followed up for 12 months, and the associations of the incidence of OSD, HBD and the degree of TT maturation were evaluated. Statistical analyses were performed by Stata 14.2. P-value less than 0.05 considered to be statistically significant. Results: Regarding the TT maturation, 27 players were at immature stage (group I), while 69 were stage 3-4 (group M). The age and HBD were not different between these two groups. During 12 months, 8 players developed OSD and the incidence was significantly greater in group I (6/27) than those of group M (2/69). Logistic regression analysis was performed to obtain odds ratios (OR) to describe the association of HBD, TT maturation and the occurrence of OSD. We found that an immature TT stage was significantly increased the risk to develop OSD (odds ratio; 6.86, 95%CI: 1.04-44.90, p<0.05), while HBD was not. Conclusion: These findings demonstrated that adolescent male football players with immature TT stage had a greater risk of incidence of OSD. Therefore, we recommend ultrasonography screening for adolescent (from 11 to 13 years old) male players as a routine medical checkup. We should consider about TT maturation when we manage adolescent players who have a symptom of OSD and modify training loads. References 1) Sailly M, Whiteley R, Johnson A. Doppler ultrasound and tibial tuberosity maturation status predicts pain in adolescent male athletes with Osgood-Schlatter’s disease: a case series with comparison group and clinical interpretation. Br J Sports Med 2013;47:93-97
THE IDEAL POSTURE IN POWER POSITION RELATED TO THE SPINAL ALIGNMENT Kazuki Fukui, Yukio Urabe, Maeda Noriaki, Shuhei Numano, Hironori Fujishita. Department of Sports Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan Introduction and Aims: The power position (PP) posture optimizes a rapid reaction in various sports. The PP usually involves a slight flexion angle of the trunk and lower extremities joints. However, no guideline has been found regarding the details of the PP's alignment angle. In a recent study, whole-body reaction time (RT) was shortened by maintaining slight flexion angle of the lower extremity joints1⁾. Nevertheless, the relationships between RT and trunk tilt (TT) and lumbar lordosis (LL) angles in the PP have not been clarified. The purpose of this study was to clarify the relationship between RT and spinal alignment in the ideal PP posture. Methods: Fifteen healthy adult males participate in this study. A Whole Body Reaction Time Measuring Instrument (Takei Inc, Japan.) with a lightflashing device and measuring mat was used to measure RT. Each subject was instructed to hop once as soon as possible after the flashing light. Subjects completed five trials, and the three measurements excluding the highest and lowest values were recorded. The alignment of standing position and PP were measured by using the Spinal Mouse (Index Inc.). Pearson’s correlation coefficient was used to determine the relationship between RT and angles of LL and TT. The significance level was set at a p value of <0.05. Result: The mean angles in the PP were as follows: RT, 315.2 ± 30.0 ms; TT, 29.4 ± 9.2 ; and LL, 6.7 ± 7.3 . In the standing position, the LL angle was 20.1 ± 5.4 . In the PP, RT and LL angle were negatively correlated (r¼ 0.56, p < 0.05). However, no correlation was observed between RT and TT angles. Conclusion: LL angle in the PP has demonstrated that has to be associated with the RT in this study. On the other hand, TT angle was not observed to be linked to the RT. Therefore, lumbar lordosis may make the best PP posture of shorten RT. References 1) Yanagishita K, et al : The effect of the postural differences for the movement speed of initiation. Jpn Soc Athlet Train 2 (1) : 37-43, 2016 KNEE VALGUS ALIGNMENT INFLUENCES THE ENERGY ABSORPTION ON THE HIP JOINT DURING A DROP VERTICAL JUMP Akihiro Tamura 1, 2, Kiyokazu Akasaka 1, 3, Takahiro Otsudo 1, 3. 1 Saitama Medical University Graduate School of Medicine, Japan; 2 Sekishindo Hospital, Japan; 3 Saitama Medical University, Japan Introduction and Aims: The impact imposed on the body during landings must be attenuated in the lower extremity joints. In particular, the hip joint plays an important role in the energy absorption during landings. On the other hand, knee valgus during landings has been associated with an increased risk of non-contact anterior cruciate ligament injuries. Therefore, the purpose of this study was to investigate whether knee valgus alignment influenced the energy absorption capacity on the hip during landings of drop vertical jumps (DVJ). Methods: Seventeen healthy females participated in this study. The 3-D motion analysis system was used to record hip joint kinetics data during the deceleration phase of DVJ. All participants were divided into the valgus (N¼10) and the varus group (N¼7), according to knee valgus/varus angles at the moment when the maximum knee flexion angle was recorded. The total negative works of the hip in the sagittal and frontal planes were calculated by integrating the joint poweretime curves during the deceleration phase, and then normalizing this according to the subject’s body weight. Unpaired t tests were used to compare changes in the variables between two groups. Results: The total negative work of the hip in the sagittal plane in the valgus group was significantly smaller than that in the varus group (valgus; -0.128±0.128J/kg, varus; -0.364±0.194J/kg, p<0.01). The total negative work of the hip in the frontal plane in the valgus group was significantly greater than that in the varus group (valgus; -0.082±0.052J/kg, varus; -0.005±0.025J/kg, p<0.05). Conclusion: The negative work of the hip in the sagittal and frontal planes represents the energy absorption through eccentric muscular contractions
Abstracts / Physical Therapy in Sport 28 (2017) e1ee25
in hip extensors and abductors, respectively. Our results indicated that knee valgus alignment was linked with reduced the capacity of energy absorption by hip extensors during landings, vice versa. Furthermore, a greater negative work of the hip in the frontal plane might be one of the biomechanical factors to cause knee valgus alignment during landings. These findings could be useful when considering the improvement of energy absorption strategy and excessive knee valgus during landings in order to prevent knee injuries. VERTICAL GROUND REACTION FORCE AND KNEE JOINT MOVEMENT DURING STOPPING MOTION ARE DIFFERENT BETWEEN DOMINANT LEG AND NON-DOMINANT LEG Takuya Takeuchi, Yukio Urabe, Shuhei Numano, Maeda Noriaki. Department of Sports Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan Introduction and Aims: Excessive vertical ground reaction force (vGRF), large knee valgus angle, and small knee flexion angle are risk factors for anterior cruciate ligament (ACL) injury1). ACL injury has been reported to occur more often in the non-dominant leg2). However, the difference in vGRF and knee joint movement between the dominant and non-dominant leg during stopping motion is unclear. The purpose of this study was to verify the difference in the magnitudes of the vGRF, knee flexion angle, and knee valgus angle between the dominant and non-dominant leg during quick stopping motion. Method: Fifteen women (21.0 ± 1.0 years, 158.5 ± 5.2 cm, 49.5 ± 3.8 kg) without any orthopedic disease participated in this study. The dominant leg was defined as the leg used to kick a ball. The dominant leg was ascertained as the right leg in 14 participants. The participants stepped forward with full force on a force plate, while the other leg remained stationary. The distance from the starting line was 50% the height of each participant. This task was performed 10 times with each leg. The task was recorded using a 3D motion analysis system. Paired t-tests were used to compare the difference between the dominant and non-dominant leg. The significance level was set at 5%. Results: The peak vGRF of the dominant leg was 22.8 ± 5.1 N/kg, while that of the non-dominant leg was 28.3 ± 5.3 N/kg (p < 0.05). The knee flexion angles of the dominant and non-dominant legs were 26.6 ± 8.8 and 28.3 ± 5.3 (p < 0.05), respectively. The knee valgus angles of the dominant and non-dominant legs were 7.6 ± 6.6 and 6.8 ± 2.7, respectively. Conclusion: The flexion of the knee joint has been reported to absorb a large amount of energy during landing. The knee joint flexion angle of the non-dominant leg was insufficient. Therefore, the difference occurred in the peak vGRF. References 1) Hewett TE, et al: Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes. Am J Sports Med 33 (4) : 492-501, 2005. 2) Urabe Y, et al: Anterior cruciate ligament injury in recreational alpine skiers analysis of mechanisms and strategy for prevention. J Orthop Sci 7 (1) : 1-5, 2002. THE EFFECTIVENESS OF ISOMETRIC CONTRACTIONS COMBINED WITH ECCENTRIC e CONCENTRIC TRAINING AND SIMPLE LUMBOPELVIC CONTROL EXERCISES ON PAIN AND DISABILITY IN CHRONIC PATELLAR TENDINOPATHY: A CASE REPORT Stasinopoulos Dimitrios. Cyprus Musculoskeletal and Sports Trauma Research Centre (CYMUSTREC), Physiotherapy Program, Dep. of Health Sciences, School of Sciences, Cyprus Introduction and Aim: Eccentric exercises are not effective for all patients with chronic patellar tendinopathy (CPT). The aim of the present case report is to present the effect of eccentric - concentric training combined with isometric contraction and simple lumbo-pelvic control exercises on pain and disability in a patient experiencing CPT. Methods: A patient with unilateral CPT for 4 months was included in the present report. The patient followed a supervised exercise five times per week for 6 weeks consisting of, isometric quadriceps exercise, and slow progressive eccentric - concentric training of quadriceps and simple
ee3
lumbo-pelvic control exercises. The programmer was individualized on the basis of the patient’s description of pain experienced during the procedure. The patient was evaluated using the VISA e P questionnaire at baseline, at the end of treatment (week 6), and 1 month (week 10) after the end of treatment. Results: VISA-P score was 42 at the initial evaluation. At the end of the treatment (week 6), there was a rise in VISA - P score of 39 units. At week 10, the VISA e P score was 86 Conclusions: The results of the present trial suggest that the combination of isometric quadriceps exercise, slow progressive eccentric concentric training of quadriceps and simple lumbo-pelvic control exercises can produce significant improvements in terms of pain and disability in CPT. THE EFFECTIVENESS OF ECCENTRIC e CONCENTRIC TRAINING AND ISOMETRIC CONTRACTIONS ON PAIN AND DISABILITY IN ACHILLES TENDINOPATHY. A CASE REPORT Stasinopoulos Dimitrios. Cyprus Musculoskeletal and Sports Trauma Research Centre (CYMUSTREC), Physiotherapy Program, Dep. of Health Sciences, School of Sciences, Cyprus Introduction and Aim: Many patients with Achilles Tendinopathy (AT) do not respond to eccentric training. The aim of the present case report is to find out the effect of eccentric - concentric training of gastrocnemius and soleus combined with isometric contraction of gastrocnemius and static stretching exercises of gastrocnemius and soleus on pain and disability in a patient experiencing AT. Methods: A patient with unilateral AT for 6 months was included in the present study. The patient followed a supervised exercise five times per week for 6 weeks consisting of, isometric gastrocnemius exercise, and slow progressive eccentric - concentric training of gastrocnemius and soleus and static stretching exercises of gastrocnemius and soleus. The programme was individualized on the basis of the patient’s description of pain experienced during the procedure. The VISA e A questionnaire was used to evaluate the patient at baseline, at the end of treatment (week 6), and 1 month (week 10) after the end of treatment. Results: VISA-A score was 39 at the initial evaluation. At the end of the treatment (week 6), there was a rise in VISA - A score of 35 units. At week 10, the VISA e A score was 81. Conclusions: The results of the present study suggest that the combination of isometric gastrocnemius exercise, slow progressive eccentric concentric training of gastrocnemius and soleus and static stretching exercises of gastrocnemius and soleus can produce significant improvements in terms of pain and disability in AT. INVESTIGATING THE RELATIONSHIP BETWEEN WORKLOAD AND THROWING INJURY IN ELITE, BASEBALL ATHLETES Sameer Mehta. Medstar Georgetown University Hospital, Department of Physical Medicine and Rehabilitation, Washington, D.C, USA Introduction and Aims: Baseball continues to be one of the most popular sports from youth to professional level but also has reported a high prevalence of injuries with a rise in Tommy John surgeries, time lost to injury, and significant revenue losses.1-3 Research focusing on injury prevention has found a link between throwing volume and upper limb injuries in youth baseball that prompted USA baseball to establish pitch limits for youth pitchers.4 Also, recent evidence from Australian sports supported that acute spikes in workload can lead to non-contact soft tissue injuries in the lower extremity, known as the acute-to-chronic workload ratio (ACWR).5 Despite this alarming rise in injury rate and ulnar collateral ligament (UCL) reconstruction there is no research investigating the relationship between workload and upper limb injury in baseball players. This is the first analysis of the relationship between acute-to-chronic valgus workload ratio (ACVR) and injury. Methods: Eighteen male baseball players (aged 17.0 ±0.7 year, height 185 ±5.7 cm, and weight 85.2 ±7.6 kg), competing at the varsity level wore the motusTHROWTM sleeve and sensor during pre—season training and the entire 2017 regular season over a six—month period. Of the eighteen athletes, four athletes were non-pitchers and the remaining fourteen
Abstracts / Physical Therapy in Sport 28 (2017) e1ee25
compare the resultant, anteroposterior, vertical, and mediolateral accelerations among the five most frequent movements that occurred during a game. Results: There were 1342 movements that generated >4 G. The top five movements were lunging during an underhand stroke with the dominant leg (264 cases, 1.52 (1.34 e 1.70) cases/min [mean (95%CI)]), landing after an overhand stroke on the non-dominant leg (164 cases, 0.94 (0.80 e 1.09) cases/min), landing after an overhand stroke on the dominant leg (161 cases, 0.93 (0.78 e 1.07) cases/min), cutting from a split step using the nondominant leg (123 cases, 0.71 (0.58 e 0.83) cases/min), and cutting from a split step using the dominant leg (118 cases, 0.68 (0.56 e 0.80) cases/min). The resultant acceleration of landing after an overhand stroke on the dominant leg was higher than that of other movements. The mediolateral acceleration of lunging during an underhand stroke with the dominant leg was higher than that of other movements. Conclusion: Landing on a single leg from an overhand stroke and lunging during an underhand stroke, which has been reported as a movement at risk for an anterior cruciate ligament injury (Kimura et al., 2010), occurred frequently with high acceleration. The accelerations were different among the five movements. Measuring trunk acceleration during actual competitive play could clarify the load and risk of injury. References Kimura, Y., et al., Br J Sports Med, 2010. 44(15): p. 1124-7. TIBIAL TUBEROSITY MATURATION COULD PREDICT THE OCCURRENCE OF OSGOOD-SCHLATTER’S DISEASE IN ADOLESCENT MALE FOOTBALL PLAYERS Naoki Akiyoshi 1, Yoshitomo Saita 2, Yohei Kobayashi 2, Keiji Kobayashi 2, Yu Kawamura 1, Hiroshi Ikeda 2. 1 Department of Rehabilitation, Oyumino Central Hospital, Japan; 2 Department of Orthopaedics and Sports Medicine, Juntendo University, School of Medicine, Japan Introduction and Aims: Osgood-Schlatter’s disease (OSD) is defined as an apophysitis of the anterior aspect of the tibial tuberosity (TT). Although TT maturation would be related to the occurrence of OSD, causal effect of TT maturation remains unclear. Therefore, we aimed to examine the relationship between the TT maturation and the incidence of OSD. Methods: Prospective analysis was conducted on 96 adolescent male football players (12.8±0.2 years old). Heel-buttock distance (HBD) was measured as a tightness of anterior thigh and ultrasonography (GE Healthcaare, LOGIQe) of TT were performed at the beginning of the season. The degree of TT maturation on ultrasonography was divided into 4 stages (stage1; cartilaginous stage, stage 2; apophyseal stage, stage 3; epiphyseal stage, stage 4; bony stage). We defined stage 1-2 as an immature stage, while stage 3-4 as a mature stage. The observed 96 players were followed up for 12 months, and the associations of the incidence of OSD, HBD and the degree of TT maturation were evaluated. Statistical analyses were performed by Stata 14.2. P-value less than 0.05 considered to be statistically significant. Results: Regarding the TT maturation, 27 players were at immature stage (group I), while 69 were stage 3-4 (group M). The age and HBD were not different between these two groups. During 12 months, 8 players developed OSD and the incidence was significantly greater in group I (6/27) than those of group M (2/69). Logistic regression analysis was performed to obtain odds ratios (OR) to describe the association of HBD, TT maturation and the occurrence of OSD. We found that an immature TT stage was significantly increased the risk to develop OSD (odds ratio; 6.86, 95%CI: 1.04-44.90, p<0.05), while HBD was not. Conclusion: These findings demonstrated that adolescent male football players with immature TT stage had a greater risk of incidence of OSD. Therefore, we recommend ultrasonography screening for adolescent (from 11 to 13 years old) male players as a routine medical checkup. We should consider about TT maturation when we manage adolescent players who have a symptom of OSD and modify training loads. References 1) Sailly M, Whiteley R, Johnson A. Doppler ultrasound and tibial tuberosity maturation status predicts pain in adolescent male athletes with Osgood-Schlatter’s disease: a case series with comparison group and clinical interpretation. Br J Sports Med 2013;47:93-97
THE IDEAL POSTURE IN POWER POSITION RELATED TO THE SPINAL ALIGNMENT Kazuki Fukui, Yukio Urabe, Maeda Noriaki, Shuhei Numano, Hironori Fujishita. Department of Sports Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan Introduction and Aims: The power position (PP) posture optimizes a rapid reaction in various sports. The PP usually involves a slight flexion angle of the trunk and lower extremities joints. However, no guideline has been found regarding the details of the PP's alignment angle. In a recent study, whole-body reaction time (RT) was shortened by maintaining slight flexion angle of the lower extremity joints1⁾. Nevertheless, the relationships between RT and trunk tilt (TT) and lumbar lordosis (LL) angles in the PP have not been clarified. The purpose of this study was to clarify the relationship between RT and spinal alignment in the ideal PP posture. Methods: Fifteen healthy adult males participate in this study. A Whole Body Reaction Time Measuring Instrument (Takei Inc, Japan.) with a lightflashing device and measuring mat was used to measure RT. Each subject was instructed to hop once as soon as possible after the flashing light. Subjects completed five trials, and the three measurements excluding the highest and lowest values were recorded. The alignment of standing position and PP were measured by using the Spinal Mouse (Index Inc.). Pearson’s correlation coefficient was used to determine the relationship between RT and angles of LL and TT. The significance level was set at a p value of <0.05. Result: The mean angles in the PP were as follows: RT, 315.2 ± 30.0 ms; TT, 29.4 ± 9.2 ; and LL, 6.7 ± 7.3 . In the standing position, the LL angle was 20.1 ± 5.4 . In the PP, RT and LL angle were negatively correlated (r¼ 0.56, p < 0.05). However, no correlation was observed between RT and TT angles. Conclusion: LL angle in the PP has demonstrated that has to be associated with the RT in this study. On the other hand, TT angle was not observed to be linked to the RT. Therefore, lumbar lordosis may make the best PP posture of shorten RT. References 1) Yanagishita K, et al : The effect of the postural differences for the movement speed of initiation. Jpn Soc Athlet Train 2 (1) : 37-43, 2016 KNEE VALGUS ALIGNMENT INFLUENCES THE ENERGY ABSORPTION ON THE HIP JOINT DURING A DROP VERTICAL JUMP Akihiro Tamura 1, 2, Kiyokazu Akasaka 1, 3, Takahiro Otsudo 1, 3. 1 Saitama Medical University Graduate School of Medicine, Japan; 2 Sekishindo Hospital, Japan; 3 Saitama Medical University, Japan Introduction and Aims: The impact imposed on the body during landings must be attenuated in the lower extremity joints. In particular, the hip joint plays an important role in the energy absorption during landings. On the other hand, knee valgus during landings has been associated with an increased risk of non-contact anterior cruciate ligament injuries. Therefore, the purpose of this study was to investigate whether knee valgus alignment influenced the energy absorption capacity on the hip during landings of drop vertical jumps (DVJ). Methods: Seventeen healthy females participated in this study. The 3-D motion analysis system was used to record hip joint kinetics data during the deceleration phase of DVJ. All participants were divided into the valgus (N¼10) and the varus group (N¼7), according to knee valgus/varus angles at the moment when the maximum knee flexion angle was recorded. The total negative works of the hip in the sagittal and frontal planes were calculated by integrating the joint poweretime curves during the deceleration phase, and then normalizing this according to the subject’s body weight. Unpaired t tests were used to compare changes in the variables between two groups. Results: The total negative work of the hip in the sagittal plane in the valgus group was significantly smaller than that in the varus group (valgus; -0.128±0.128J/kg, varus; -0.364±0.194J/kg, p<0.01). The total negative work of the hip in the frontal plane in the valgus group was significantly greater than that in the varus group (valgus; -0.082±0.052J/kg, varus; -0.005±0.025J/kg, p<0.05). Conclusion: The negative work of the hip in the sagittal and frontal planes represents the energy absorption through eccentric muscular contractions
Abstracts / Physical Therapy in Sport 28 (2017) e1ee25
in hip extensors and abductors, respectively. Our results indicated that knee valgus alignment was linked with reduced the capacity of energy absorption by hip extensors during landings, vice versa. Furthermore, a greater negative work of the hip in the frontal plane might be one of the biomechanical factors to cause knee valgus alignment during landings. These findings could be useful when considering the improvement of energy absorption strategy and excessive knee valgus during landings in order to prevent knee injuries. VERTICAL GROUND REACTION FORCE AND KNEE JOINT MOVEMENT DURING STOPPING MOTION ARE DIFFERENT BETWEEN DOMINANT LEG AND NON-DOMINANT LEG Takuya Takeuchi, Yukio Urabe, Shuhei Numano, Maeda Noriaki. Department of Sports Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan Introduction and Aims: Excessive vertical ground reaction force (vGRF), large knee valgus angle, and small knee flexion angle are risk factors for anterior cruciate ligament (ACL) injury1). ACL injury has been reported to occur more often in the non-dominant leg2). However, the difference in vGRF and knee joint movement between the dominant and non-dominant leg during stopping motion is unclear. The purpose of this study was to verify the difference in the magnitudes of the vGRF, knee flexion angle, and knee valgus angle between the dominant and non-dominant leg during quick stopping motion. Method: Fifteen women (21.0 ± 1.0 years, 158.5 ± 5.2 cm, 49.5 ± 3.8 kg) without any orthopedic disease participated in this study. The dominant leg was defined as the leg used to kick a ball. The dominant leg was ascertained as the right leg in 14 participants. The participants stepped forward with full force on a force plate, while the other leg remained stationary. The distance from the starting line was 50% the height of each participant. This task was performed 10 times with each leg. The task was recorded using a 3D motion analysis system. Paired t-tests were used to compare the difference between the dominant and non-dominant leg. The significance level was set at 5%. Results: The peak vGRF of the dominant leg was 22.8 ± 5.1 N/kg, while that of the non-dominant leg was 28.3 ± 5.3 N/kg (p < 0.05). The knee flexion angles of the dominant and non-dominant legs were 26.6 ± 8.8 and 28.3 ± 5.3 (p < 0.05), respectively. The knee valgus angles of the dominant and non-dominant legs were 7.6 ± 6.6 and 6.8 ± 2.7, respectively. Conclusion: The flexion of the knee joint has been reported to absorb a large amount of energy during landing. The knee joint flexion angle of the non-dominant leg was insufficient. Therefore, the difference occurred in the peak vGRF. References 1) Hewett TE, et al: Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes. Am J Sports Med 33 (4) : 492-501, 2005. 2) Urabe Y, et al: Anterior cruciate ligament injury in recreational alpine skiers analysis of mechanisms and strategy for prevention. J Orthop Sci 7 (1) : 1-5, 2002. THE EFFECTIVENESS OF ISOMETRIC CONTRACTIONS COMBINED WITH ECCENTRIC e CONCENTRIC TRAINING AND SIMPLE LUMBOPELVIC CONTROL EXERCISES ON PAIN AND DISABILITY IN CHRONIC PATELLAR TENDINOPATHY: A CASE REPORT Stasinopoulos Dimitrios. Cyprus Musculoskeletal and Sports Trauma Research Centre (CYMUSTREC), Physiotherapy Program, Dep. of Health Sciences, School of Sciences, Cyprus Introduction and Aim: Eccentric exercises are not effective for all patients with chronic patellar tendinopathy (CPT). The aim of the present case report is to present the effect of eccentric - concentric training combined with isometric contraction and simple lumbo-pelvic control exercises on pain and disability in a patient experiencing CPT. Methods: A patient with unilateral CPT for 4 months was included in the present report. The patient followed a supervised exercise five times per week for 6 weeks consisting of, isometric quadriceps exercise, and slow progressive eccentric - concentric training of quadriceps and simple
ee3
lumbo-pelvic control exercises. The programmer was individualized on the basis of the patient’s description of pain experienced during the procedure. The patient was evaluated using the VISA e P questionnaire at baseline, at the end of treatment (week 6), and 1 month (week 10) after the end of treatment. Results: VISA-P score was 42 at the initial evaluation. At the end of the treatment (week 6), there was a rise in VISA - P score of 39 units. At week 10, the VISA e P score was 86 Conclusions: The results of the present trial suggest that the combination of isometric quadriceps exercise, slow progressive eccentric concentric training of quadriceps and simple lumbo-pelvic control exercises can produce significant improvements in terms of pain and disability in CPT. THE EFFECTIVENESS OF ECCENTRIC e CONCENTRIC TRAINING AND ISOMETRIC CONTRACTIONS ON PAIN AND DISABILITY IN ACHILLES TENDINOPATHY. A CASE REPORT Stasinopoulos Dimitrios. Cyprus Musculoskeletal and Sports Trauma Research Centre (CYMUSTREC), Physiotherapy Program, Dep. of Health Sciences, School of Sciences, Cyprus Introduction and Aim: Many patients with Achilles Tendinopathy (AT) do not respond to eccentric training. The aim of the present case report is to find out the effect of eccentric - concentric training of gastrocnemius and soleus combined with isometric contraction of gastrocnemius and static stretching exercises of gastrocnemius and soleus on pain and disability in a patient experiencing AT. Methods: A patient with unilateral AT for 6 months was included in the present study. The patient followed a supervised exercise five times per week for 6 weeks consisting of, isometric gastrocnemius exercise, and slow progressive eccentric - concentric training of gastrocnemius and soleus and static stretching exercises of gastrocnemius and soleus. The programme was individualized on the basis of the patient’s description of pain experienced during the procedure. The VISA e A questionnaire was used to evaluate the patient at baseline, at the end of treatment (week 6), and 1 month (week 10) after the end of treatment. Results: VISA-A score was 39 at the initial evaluation. At the end of the treatment (week 6), there was a rise in VISA - A score of 35 units. At week 10, the VISA e A score was 81. Conclusions: The results of the present study suggest that the combination of isometric gastrocnemius exercise, slow progressive eccentric concentric training of gastrocnemius and soleus and static stretching exercises of gastrocnemius and soleus can produce significant improvements in terms of pain and disability in AT. INVESTIGATING THE RELATIONSHIP BETWEEN WORKLOAD AND THROWING INJURY IN ELITE, BASEBALL ATHLETES Sameer Mehta. Medstar Georgetown University Hospital, Department of Physical Medicine and Rehabilitation, Washington, D.C, USA Introduction and Aims: Baseball continues to be one of the most popular sports from youth to professional level but also has reported a high prevalence of injuries with a rise in Tommy John surgeries, time lost to injury, and significant revenue losses.1-3 Research focusing on injury prevention has found a link between throwing volume and upper limb injuries in youth baseball that prompted USA baseball to establish pitch limits for youth pitchers.4 Also, recent evidence from Australian sports supported that acute spikes in workload can lead to non-contact soft tissue injuries in the lower extremity, known as the acute-to-chronic workload ratio (ACWR).5 Despite this alarming rise in injury rate and ulnar collateral ligament (UCL) reconstruction there is no research investigating the relationship between workload and upper limb injury in baseball players. This is the first analysis of the relationship between acute-to-chronic valgus workload ratio (ACVR) and injury. Methods: Eighteen male baseball players (aged 17.0 ±0.7 year, height 185 ±5.7 cm, and weight 85.2 ±7.6 kg), competing at the varsity level wore the motusTHROWTM sleeve and sensor during pre—season training and the entire 2017 regular season over a six—month period. Of the eighteen athletes, four athletes were non-pitchers and the remaining fourteen