Does lower extremity alignment during normal stance predict lower limb kinematics and kinetics during drop landings?

Abstract

Background: Static lower extremity alignment (LEA) during normal stance has been used clinically as a tool to determine the presence of known anterior cruciate ligament (ACL) risk factors during dynamic tasks. Previous work investigating the relationship between static LEA during normal stance and risk factors for ACL injury is limited by the use of imprecise methods or because it focuses on knee valgus only and no other potentially important variables. The aim of this investigation was to determine the relationships between static LEA and the corresponding LEA during drop landings. Methods: Forty-one female athletes were recruited for the study (age: 19.8 ± 2.5 years, height: 1.73 ± 0.06 m, mass: 64.03 ± 6.66 kg). Lower limb kinematic data were collected using a 10 camera infrared motion capture system (500 Hz) with retro-reflective markers placed over key anatomical landmarks. This system was linked to two force platforms (1000 Hz) with subsequent three-dimensional kinematic and kinetic data developed using standard software (Visual3D). Following an appropriate warm-up, data collection involved participants standing with their arms partially abducted to record static LEA. This was following by a series of drop landings from a 0.4 m box onto the force platforms. Maximum LEA data during drop landings were then compared with static LEA. Results: Analyses showed that in comparison to static stance, during landings the anterior tilt of the pelvis decreased while hip abduction and knee internal rotation increased. At best, static LEA variables were moderately correlated (r = -0.51 to 0.58) with peak values measured during drop landings. Additionally, regression analysis did not yield any significant predictors of any key peak hip or knee variables measured during drop landings (p = 0.15 to 0.89). Conclusion: When combined, the poor relationships observed between kinematics during static LEA and LEA during drop landings calls into question the practice of using static measures to predict LEA during even simple landing tasks. These findings suggest static assessments of LEA may have minimal value as an ACL injury screening tool.