Optimizing whole-body kinematics to minimize valgus knee loading during sidestepping: Implications for ACL injury risk

Abstract The kinematic mechanisms associated with elevated externally applied valgus knee moments during non-contact sidestepping and subsequent anterior cruciate ligament (ACL) injury risk are not well understood. To address this issue, the residual reduction algorithm (RRA) in OpenSim was used to...

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Bibliographic Details
Published in:Journal of biomechanics 2012-05, Vol.45 (8), p.1491-1497
Main Authors: Donnelly, C.J, Lloyd, D.G, Elliott, B.C, Reinbolt, J.A
Format: Article
Language:English
Subjects:
Algorithms
Anterior Cruciate Ligament - physiopathology
Anterior Cruciate Ligament Injuries
Biological and medical sciences
Computer Simulation
Football - physiology
Fundamental and applied biological sciences. Psychology
Humans
Injuries
Injuries of the limb. Injuries of the spine
Injury
Injury prevention
Kinematics
Knee
Knee Injuries - physiopathology
Knee Injuries - prevention & control
Knee Joint - physiopathology
Knees
Male
Medical sciences
Models, Biological
Optimization
Physical Medicine and Rehabilitation
Prevention
Risk
Simulation
Sports injuries
Sports medicine
Studies
Technique
Traumas. Diseases due to physical agents
Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports
Weight-Bearing - physiology
Young Adult
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Summary:Abstract The kinematic mechanisms associated with elevated externally applied valgus knee moments during non-contact sidestepping and subsequent anterior cruciate ligament (ACL) injury risk are not well understood. To address this issue, the residual reduction algorithm (RRA) in OpenSim was used to create nine subject-specific, full-body (37 degrees of freedom) torque-driven simulations of athletic males performing unplanned sidestep (UnSS) sport tasks. The RRA was used again to produce an optimized kinematic solution with reduced peak valgus knee torques during the weight acceptance phase of stance. Pre-to-post kinematic optimization, mean peak valgus knee moments were significantly reduced by 44.2 Nm ( p =0.045). Nine of a possible 37 upper and lower body kinematic changes in all three planes of motion were consistently used during the RRA to decrease peak valgus knee moments. The generalized kinematic strategy used by all nine simulations to reduce peak valgus knee moments and subsequent ACL injury risk during UnSS was to redirect the whole-body center of mass medially, towards the desired direction of travel.
ISSN:0021-9290
1873-2380
DOI:10.1016/j.jbiomech.2012.02.010