Full length articleDirections of single-leg landing affect multi-segment foot kinematics and dynamic postural stability in male collegiate soccer athletes
Introduction
Ankle sprains are frequently reported sports injuries [1]. The reported incidence is 11.55 ankle sprains per 1000 exposures [2], with lateral ankle ligament sprain having the highest incidence (3.02 per 1000 person-years) than other ankle sprains (medial: 0.0086, high: 0.0062 per 1000 person-years) [3]. Lateral ankle sprains tend to occur during landing and sideward cutting movements and usually occur when the foot touches the ground and the ankle joint is suddenly inverted with low levels of plantar flexion with and without internal rotation [4,5]. To prevent lateral ankle ligament sprains, it is important to control the lower limb joint so that the ankle does not result in inversion during a landing.
Postural stability is considered an intrinsic risk factor in ankle sprains and has been mostly evaluated with single-leg standing [6,7], despite ankle sprains usually occurring at the moment of landing [4,5]. As an ankle sprain screening test, we should evaluate the postural stability with landing tasks. A commonly applied landing postural stability outcome measures is the time to stabilization (TTS), which reflects the time required for an individual to stabilize to a stable posture after landing [[8], [9], [10], [11], [12]]. The TTS can be evaluated separately for vertical, anteroposterior, and mediolateral ground reaction force components (GRFs). Thus, it is suitable for comparing joint kinematics and dynamic postural stability [11]. Similarly, landing parameters such as impact force [9,13] and dynamic balance [9] calculated by GRFs are efficient tools to evaluate postural control.
Gait and landing kinematics focusing on the foot are gradually being clarified [[14], [15], [16], [17], [18]], and the importance of multi-segmented foot and ankle assessment from a clinical and research perspective has been emphasized [19]. The three-segmented foot model, which divides the foot regions into the rearfoot, midfoot, and forefoot, has been used to evaluate feet kinematics [14,15]. 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. However, most studies have examined lower limb biomechanics with forward direction landing tasks [8,9,11,17,23], therefore, the influence of landing directions on the lower limbs and foot kinematics in the frontal plane and dynamic postural stabilities are unknown.
This study examined frontal plane kinematics in the lower limb and foot, postural stability, and landing parameters during single-leg landings in three different directions. We hypothesized that if the landing direction deviates for medial or lateral direction compared to forward landing, the lower limb and foot frontal plane kinematics related to the deviated direction may be altered with corresponding increases in mediolateral GRFs, and the TTS mediolateral also will be slower. Additionally, landing parameters related to horizontal plane may be affected.
Section snippets
Participants
A one-within repeated measures design was used. An a priori sample size estimation with an effect size of 0.4, alpha level of 0.01, and a statistical power of 0.8 using the calculation G*Power 3.1, revealed that a minimum of 43 subjects would be required. Overall, 49 soccer players (aged: 19.39±3.07 years, height: 173.60±7.30 cm, weight: 66.98±7.32 kg) participated in this study. All subjects attended daily soccer training (6 times/week), and none complained of ankle instability. The perceived
Curve analysis
Results of the SPMANOVA are shown in Fig. 2. A comparison of each landing found greater hip abduction from 0 to 88 % in the LL compared to the FL, and greater hip adduction in the ML compared to the FL and LL (Fig. 3). The LL showed greater knee valgus from 0 to 12 % compared to the FL, and from 0 to 10 % compared to the ML, and smaller knee valgus from 42 to 50 % compared to the FL, and from 31 to 100 % compared to the ML (Fig. 3). The LL showed smaller ankle eversion from 4 to 100 % compared
Discussion
Our study showed that differences in the directions of single-leg landing affected the lower limb and foot frontal plane kinematics related to deviated directions, which was consistent with our hypothesis. In particular, the ankle and rearfoot joint in the LL showed a more inverted and supinated position compared to the FL and ML. Additionally, the TTS-ML, GRFML0.4, loading rate, HGRF-0.4 and -2.4 in the LL had higher values compared to the FL.
Ethical statements
All participants provided informed consent and the study protocol was approved by the institutional review board (No. 30-21).
Funding
This work was supported by JSPS KAKENHI [grant number JP18K17709]. The funding source had no involvement in study design, collection, analysis and interpretation of data, in writing the manuscript, or in the decision to submit for publication.
Declaration of Competing Interest
There are no conflicts of interest to declare.
Acknowledgments
We would like to thank Todd C. Pataky for SPM, and Editage (www.editage.jp) for English language editing.
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