Jump-landing direction influences dynamic postural stability scores

doi:10.1016/j.jsams.2007.02.014

Journal of Science and Medicine in Sport

Volume 11, Issue 2, April 2008, Pages 106-111

https://doi.org/10.1016/j.jsams.2007.02.014 Get rights and content

Summary

The purpose of this investigation was to determine dynamic postural stability differences among forward, diagonal, and lateral single leg-hop-stabilization protocols in healthy subjects. A one-within repeated measures design was used to determine the effects of jump direction on dynamic postural stability during landing. Subjects were required to perform a two-legged forward, diagonal, and lateral jump to a height equivalent to 50% of their maximum vertical leap, land on a single leg and balance for three seconds. Twenty-six subjects [10 males (22 ± 3.9 years of age, 70.9 ± 7.6 kg, and 176.8 ± 6.5 cm) and 16 females (20.6 ± .5 years of age, 65.6 ± 9.1 kg, and 166.4 ± 5.9 cm)] volunteered to participate in this investigation. Dynamic postural stability indices for the anterior/posterior, medial/lateral, and vertical planes were collected during jump-landing trials of each direction. The results of the investigation show that medial/lateral and vertical dynamic postural stability were significantly affected by the direction of the jump. More specifically, lateral and diagonal jump-landings produce increased medial/lateral stability index (MLSI) scores and forward jump-landings produce increased vertical stability index (VSI) scores. The results suggest that in a healthy population, jump protocol direction will statistically affect dynamic postural stability in the frontal and vertical planes. These alterations could be exacerbated in individuals with lower extremity impairments and further research is warranted.

Introduction

Approximately 50,000 anterior cruciate ligament (ACL) reconstructions are performed each year in the United States causing a financial impact of $850 million per annum.¹ Furthermore, the occurrence of ankle sprains has been estimated to be 5000 every day in the United Kingdom² and between 23,000 and 27,000 every day in the United States.2, 3 Based on two investigations, the annual aggregate dollar expenditure for moderate to severe ankle sprains in the United States was estimated to be approximately $3.65 billion in 2003. As a result, the need to conduct more functional and dynamic testing has emerged. Therefore, the examination of lower extremity dynamic joint stability has become a focus of many clinicians and biomechanists around the world.

The ankle and knee joints rely heavily on the dynamic restraints (muscular stiffness) of the lower extremity in an attempt to prevent injury, which has been suggested to provide greater joint stability.4, 5 More specific, it is thought that preparatory muscle activity is primarily responsible for joint protection.6, 7 One technique to indirectly measure muscular stiffness is dynamic postural stability. McKinely and Pedotti indicated that subjects with greater and earlier preparatory muscle activity demonstrated improved dynamic postural stability scores.⁶ Currently, two measures of dynamic postural stability are mentioned in the literature: (1) time to stabilization and (2) the dynamic postural stability index (DPSI). Both measures determine how well balance can be maintained while transitioning from a dynamic to static state and are also functional measurements of neuromuscular control because they are calculated during a single-leg-hop-stabilization protocol. However, the DPSI was found to be a more reliable (ICC = 0.96) and precise (standard error of the measure = 0.03) measure of dynamic postural stability than time to stabilization.⁸

The majority of previous investigations have focused on pathologies; specifically anterior cruciate ligament (ACL) deficiency or ankle instability. Time to stabilization evaluated differences among healthy, ACL deficient, and ACL reconstructed patients,⁹ and between healthy and ankle instability patients.10, 11, 12 Similarly, the DPSI examined differences between healthy and ankle instability patients.²⁴ However, all of the aforementioned investigations used a forward jump-landing protocol despite a lack of empirical evidence supporting its use. Examining the differences in dynamic postural stability among different jump-landing directions could reveal previously overlooked information regarding neuromuscular control and may allow clinicians and researchers to develop better injury prevention strategies in a clinical population. Therefore, the purpose of this investigation was to evaluate how dynamic postural stability is affected when performing a jump-landing task in three different directions (forward, diagonal, lateral) using the DPSI.

Section snippets

Subjects and design

A one-within repeated measures design was used to determine if jump-landing direction (forward, diagonal, lateral) would affect dynamic postural stability. Twenty-six recreationally active subjects [10 males (22 ± 3.9 years of age, 70.9 ± 7.6 kg, and 176.8 ± 6.5 cm) and 16 females (20.6 ± 0.5 years of age, 65.6 ± 9.1 kg, and 166.4 ± 5.9 cm)] volunteered to participate in this investigation. Recreationally active was operationally defined as exercising at least three times a week for a minimum of 30 min each.

Results

The group means, standard deviations and effect sizes for the directional DPSI can be seen in Table 2. The MLSI revealed a significant difference among directions [F(2, 50) = 41.41, p < .001]. Tukey's-post-hoc (HSD = 0.021) test showed that all three directions were significantly different from each other with α = 0.05. More specifically, the lateral jump-landing protocol produced significantly higher scores than the diagonal and forward jump-landing protocol. In addition, the diagonal jump-landing

Discussion

It is thought that lower extremity joints are stressed regardless of direction during a jump protocol. This is due to the functional anatomy of the lower extremity joints which allow tri-planar motion.17, 18 Therefore, pathological groups which have shown dynamic postural stability deficits (i.e. ACL deficient, or chronic ankle instability) could be tested using any jump-landing direction and still have their postural control deficits exposed. For example, previous work by Ross et al. has

Conclusions

The results of this investigation indicate that in a healthy population, the direction of the jump protocol will affect dynamic postural stability in the frontal and vertical planes. More specifically, lateral and diagonal jump-landings produce increased MLSI scores and forward jump-landings produce increased VSI scores. As a result of the current findings, we can conclude that conducting all research with a forward jump-landing protocol is not entirely valid to evaluate causes and prevention

Practical implications

•
Using forward jump-landing protocols alone, may mask potentially harmful deficits when conducting an investigation or making a return to play decision.
•
Researchers and clinicians need to vary the selection of the jump-landing protocol according to the athlete or group of athletes that they are testing.

References (24)

C. Frank et al.
The science of reconstruction of the anterior cruciate ligament
J Bone Joint Surg Am
(1997)
P. Kannus et al.
Treatment for acute tears of the lateral ligaments of the ankle: operation, cast, or early controlled mobilization
J Bone Joint Surg
(1991)
J. Baumhauer et al.
A prospective study of ankle injury risk factors
Am J Sport Med
(1995)
B. Riemann et al.
The sensorimotor system, part II: The role of proprioception in motor control and functional joint stability
J Athl Train
(2002)
S. Griller
A role for muscle stiffness in meeting the changing postural and locomotor requirements for force development by ankle extensors
Acta Physiol Scand
(1972)
P. McKinely et al.
Motor strategies in landing from a jump: the role of skill in task execution
Exp Brain Res
(1992)
E. Wikstrom et al.
Dynamic joint stability in the lower extremity
Sports Med
(2006)
E. Wikstrom et al.
New force plate technology measure of dynamic stability: The dynamic stability index
J Athl Train
(2005)
S. Colby et al.
Lower limb stability with ACL impairment
J Orthop Sports Phys Ther
(1999)
B. Brown et al.
Assessing functional ankle instability with joint position sense, time to stabilization, and electromyography
J Sport Rehabil
(2004)

S. Ross et al.

Single-leg jump-stabilization times in subjects with functionally unstable ankles

J Athl Train

(2005)

S. Ross et al.

Examination of static and dynamic postural stability in individuals with functionally stable and unstable ankles

Clin J Sport Med

(2004)

Cited by (54)

The influence of jump-landing direction on dynamic postural stability following anterior cruciate ligament reconstruction
2024, Clinical Biomechanics
Traditional testing prior to return to sport following anterior cruciate ligament reconstruction typically involves jump-landing tasks in the forward direction. As injury is most likely the result of multiplanar neuromuscular control deficits, assessment of dynamic postural stability using landing tasks that require multiplanar stabilization may be more appropriate. The purpose of this study was to examine how dynamic postural stability is affected when performing jump-landing tasks in three different directions.
Fifteen athletes [11 females (18.0 ± 3.0 years) and 4 males (18.5 ± 3.1 years)] following anterior cruciate ligament reconstruction performed a series of single-limb jump-landing tasks in 3 directions. Individual directional stability indices and a composite dynamic postural stability index were calculated using ground reaction force data and were compared using separate one-way repeated measures ANOVAs.
All directional stability indices demonstrated a significant main effect for jump-landing direction (medial-lateral P < 0.001, η²p = 0.95; anterior-posterior P < 0.001, η²p = 0.97; vertical P = 0.021, η²p = 0.24). The diagonal jump-landing direction produced increased medial-lateral stability and vertical stability scores, while the forward and diagonal jump-landing directions produced increased anterior-posterior stability scores. There was no significant effect for the composite dynamic stability index score.
Jump-landing direction affects dynamic postural stability in all 3 planes of movement in athletes following anterior cruciate ligament reconstruction. Results indicate the potential need to incorporate multiple jump-landing directions to better assess dynamic postural stability prior to return to sport.
Lower limb kinematics during single leg landing in three directions in individuals with chronic ankle instability
2022, Physical Therapy in Sport
Citation Excerpt :
Previous studies on healthy individuals have shown that the landing direction affects lower limb kinematics and dynamic postural stability. The ankle inversion angle is greater and the time to postural stability is longer in lateral landing than in forward landing (Azevedo et al., 2019; Kunugi et al., 2020; Wikstrom et al., 2008). This may cause a greater load on the muscles and ligaments that resist ankle inversion.
To compare the lower limb kinematics of participants with chronic ankle instability (CAI) and healthy participants during forward, lateral, and medial landings.
Cross-sectional study.
Laboratory.
Eighteen athletes with CAI and 18 control athletes.
Hip, knee, and ankle joint kinematics during forward, lateral, and medial single-leg landings were compared between the groups using two-way ANOVA for discrete values and statistical parametric mapping two-sample t-tests for time-series data.
The CAI group had significantly greater ankle dorsiflexion than the control group (P ≤ 0.013), which was observed from the pre-initial contact (IC) for lateral and medial landings and post-IC for forward landing. The CAI group showed greater knee flexion than the control group from the IC for lateral landing and post-IC for forward landing (P ≤ 0.014). No significant differences in ankle inversion kinematics were found between the CAI and control groups. Lateral landing had a greater peak inversion angle and velocity than forward and medial landings (P < 0.001). Medial landing had a greater inversion velocity than forward landing (P < 0.001).
This study suggests that individuals with CAI show feedforward protective adaptations in the pre-landing phase for lateral and medial landings.
Directions of single-leg landing affect multi-segment foot kinematics and dynamic postural stability in male collegiate soccer athletes
2020, Gait and Posture
Citation Excerpt :
The evaluation of foot and ankle kinematics in landing will be useful to prevent lateral ankle sprains. Landing directions have been reported to affect frontal plane kinematics in the knee [20], hip, and ankle [21], and dynamic postural stabilities [12,22]. Foot and ankle kinematics may also be influenced by directions in landing.
Understanding lower limb kinematics and postural control in different directions of single-leg landings is critical to evaluate postural control and prevent lower limb injuries. However, foot and ankle kinematics and postural control during single-leg landings in different directions are less known.
Does the difference in the direction of single-leg landing affect the foot kinematics on the frontal plane and dynamic postural stability?
A cross-sectional study was conducted. Forty-nine male collegiate soccer players performed single-leg forward (FL), 45° lateral (LL), and medial (ML) direction landings. The lower limb, foot (rearfoot, midfoot, forefoot), and ankle kinematics during an impact phase were evaluated, and a curve analysis was performed using a statistical parametric mapping method to compare the three landings. The three landings were compared in terms of postural control parameters, including time to stabilization (TTS), peak of ground reaction forces (GRFs), root-mean-square of the mediolateral GRFs for 0–0.4 s (GRFML0.4), loading rate, and magnitude of horizontal GRFs from 0–0.4 s (HGRF-0.4), 0.4–2.4 s (HGRF-2.4), and 3.0–5.0 s.
Ankle and rearfoot kinematics in LL exhibited smaller eversion and pronation positions than FL and ML (p < 0.01). The TTS-mediolateral (TTS-ML) was longer in the LL than in FL and ML (p < 0.001). The GRFML0.4, HGRF-0.4, and -2.4 in the LL and ML were greater than those in the FL (p < 0.001).
Directions of single-leg landing affect foot and ankle kinematics and postural stability. Specifically, the LL exhibits more inverted ankle and supinated rearfoot positions, and longer TTS-ML. Thus, the LL may induce stretching of the lateral ankle ligament. These findings can help understand foot kinematics and assess dynamic postural control.
Oxford foot model kinematics in landings: A comparison between professional dancers and non-dancers
2020, Journal of Science and Medicine in Sport
Dancers frequently perform jump-landing activities, with the foot-ankle complex playing an essential role to attenuate the landing forces. However, scarce research has been conducted in professional dancers multi-segmented foot in landings. The aim of this study was to compare the multi-segmented foot kinematics between professional dancers and non-dancers, during forward and lateral single-leg jump-landings.
Descriptive group comparison.
Marker trajectories and synchronized ground reaction forces of 15 professional dancers and 15 non-dancers were collected using motion capture and a force plate, during multidirectional single-leg jump-landings. Sagittal and frontal hindfoot-tibia, forefoot-hindfoot, and hallux-forefoot kinematics of the multi-segmented foot model were computed at initial contact, peak vertical ground reaction force and peak knee flexion. Repeated measures ANOVAs were conducted (p < 0.05).
Professional dancers landed with higher hindfoot-tibia and forefoot-hindfoot plantarflexion angles at initial contact (p < 0.001), and hindfoot-tibia dorsiflexion angles at peak vertical ground reaction force and peak knee flexion (p < 0.001) than non-dancers. Also, dancers exhibited higher sagittal hindfoot-tibia and forefoot-hindfoot excursions than non-dancers (p < 0.001). No statistically significant differences were found in the frontal plane.
The multi-segmented foot allows a comprehensive kinematic analysis of the different foot joints. In jump-landings, professional dancers higher hindfoot-tibia, and forefoot-hindfoot plantarflexion at initial contact, compared to non-dancers, contributed to a subsequent higher foot joints excursion. This pattern is commonly linked to a better shock absorption mechanism in landings.
Foot modeling affects ankle sagittal plane kinematics during jump-landing
2019, Journal of Biomechanics
Citation Excerpt :
Before the static trial, a 5-minute self-directed warm-up was provided. Participants stood on the non-dominant leg, 70 cm away from the center of the force plate (Wikstrom et al., 2008), then randomly performed lateral (LJ) and forward (FJ) single-leg jump-landings (Taylor et al., 2016; Wikstrom et al., 2008), landed on the dominant leg, in the force plate center. Upon landing, participants immediately transitioned into a maximal vertical jump, followed by a second landing in the force plate center.
The foot-ankle complex is a key-element to mitigate impact forces during jump-landing activities. Biomechanical studies commonly model the foot as a single-segment, which can provide different ankle kinematics compared to a multi-segmented model. Also, it can neglect intersegmental kinematics of the foot-ankle joints, such as the hindfoot-tibia, forefoot-hindfoot, and hallux-forefoot joints, that are used during jump-landing activities. The purpose of this short communication was to compare ankle kinematics between a three- and single-segmented foot models, during forward and lateral single-leg jump-landings. Marker trajectories and synchronized ground reaction forces of 30 participants were collected using motion capture and a force plate, during multidirectional single-leg jump-landings. Ankle kinematics were computed using a three- (hindfoot-tibia) and a single-segmented (ankle) foot models, at initial contact (IC), peak vertical ground reaction force (PvGRF) and peak knee flexion (PKF). Repeated measures ANOVAs were conducted (p < 0.05). The findings of this study showed that during lateral and forward jump-landing directions, the three-segmented foot model exhibited lower hindfoot-tibia dorsiflexion angles (PvGRF and PKF, p < 0.001) and excursions (sagittal: p < 0.001; frontal: p < 0.05) during the weightbearing acceptance phase than the single-segmented model. Overall, the two foot models provided distinctive sagittal ankle kinematics, with lower magnitudes in the hindfoot-tibia of the three-segmented foot. Furthermore, the three-segmented foot model may provide additional and representative kinematic data of the ankle and foot joints, to better comprehend its function, particularly in populations whose foot-ankle complex plays an important role (e.g., dancers).
Test–retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests
2019, Knee
Citation Excerpt :
Each of the hop tests required a different challenge to the individual. From a biomechanical perspective, jump-landing direction significantly influences lower extremity biomechanics [47–49] and dynamic postural stability outcomes [50,51]. It could be hypothesized that MSTH and MRH are more likely to provoke a movement pattern including hip adduction, hip medial rotation and knee valgus during landing [36].
Single-leg hop tests are commonly performed in the forward direction to evaluate functional performance. However, athletes move in multiple directions during pivoting sports. The first aim of this study was to examine test–retest reliability of single-leg hop tests in the forward, medial and rotational direction in non-injured athletes. Second, the discriminative ability to detect leg asymmetries with these hop tests in anterior cruciate ligament (ACL) reconstructed athletes was determined.
Sixteen recreational non-injured participants (eight females, eight males; 22.4 ± 1.9 years) were tested twice (one-week interval) and performed the single hop for distance (SH), triple hop for distance (TH), medial side triple hop for distance (MSTH) and 90° medial rotation hop for distance (MRH). Intraclass correlation coefficients (ICCs), standard errors of measurement (SEM) and smallest detectable differences (SDD) were calculated. Discriminative ability was determined in 32 ACL-reconstructed participants (four females, 28 males; 24.4 ± 4.6 years; six months postoperative) who performed the same hop tests once.
The ICCs ranged between 0.93 and 0.98. The SEM and SDD were respectively 2.6–4.1% and 7.2–11.3% of the mean hop distance of the group. The proportion (%) of ACL-reconstructed participants passing the ≥ 90% limb symmetry cut-off was 62.5 (SH), 59.4 (TH), 40.6 (MSTH) and 46.9 (MRH).
Excellent test–retest reliability of forward, medial and rotational hop tests was found. This allows clinicians to make informed interpretations of changes in hop test distances when retesting athletes. Medial and rotational hop tests are more likely to show limb asymmetries in ACL-reconstructed participants compared to forward hop tests.

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Original paperJump-landing direction influences dynamic postural stability scores

Summary

Introduction

Section snippets

Subjects and design

Results

Discussion

Conclusions

Practical implications

The science of reconstruction of the anterior cruciate ligament

J Bone Joint Surg Am

Treatment for acute tears of the lateral ligaments of the ankle: operation, cast, or early controlled mobilization

J Bone Joint Surg

A prospective study of ankle injury risk factors

Am J Sport Med

The sensorimotor system, part II: The role of proprioception in motor control and functional joint stability

J Athl Train

A role for muscle stiffness in meeting the changing postural and locomotor requirements for force development by ankle extensors

Acta Physiol Scand

Motor strategies in landing from a jump: the role of skill in task execution

Exp Brain Res

Dynamic joint stability in the lower extremity

Sports Med

New force plate technology measure of dynamic stability: The dynamic stability index

J Athl Train

Lower limb stability with ACL impairment

J Orthop Sports Phys Ther

Assessing functional ankle instability with joint position sense, time to stabilization, and electromyography

J Sport Rehabil

Single-leg jump-stabilization times in subjects with functionally unstable ankles

J Athl Train

Examination of static and dynamic postural stability in individuals with functionally stable and unstable ankles

Clin J Sport Med

Original paper
Jump-landing direction influences dynamic postural stability scores