Testing for neuromuscular problems and athletic performance

Abstract

This chapter reviews cost-effective tests to determine neuromuscular deficiencies and indicators of athletic performance. The identification of athletes who may have an increased risk of sustaining a noncontact ACL rupture is highly important in the continued development of knee injury prevention programs. No single test has been found to be highly predictive of at-risk athletes. Common body mechanics and injury circumstances have been noted during or just following ACL ruptures, such as reduced knee flexion angles, increased hip flexion angles, valgus collapse at the knee, reduced ankle plantar flexion angles (flat-footed position), increased hip internal rotation, and increased internal or external tibial rotation. Cost-effective tests are recommended that depict these abnormal mechanics during activities such as landing from a jump, cutting, or sidestepping. Field tests are described that are commonly used to estimate maximal oxygen uptake and measure speed, agility, vertical jump height, dynamic balance, and strength before and after ACL intervention training. Other testing options that require sophisticated equipment (such as magnetic resonance imaging) are presented for anatomical indices (intercondylar notch, tibial slope) that appear to play a role in ACL injury risk. The potential importance of performance scores on neurocognitive (concussion) tests is discussed.