NON-CONTACT ANTERIOR CRUCIATE LIGAMENT AND LOWER EXTREMITY INJURY RISK PREDICTION USING FUNCTIONAL MOVEMENT SCREEN AND KNEE ABDUCTION MOMENT: AN EPIDEMIOLOGICAL OBSERVATION OF FEMALE INTERCOLLEGIATE ATHLETES

Abstract

Background: Modifiable risk factors associated with non-contact anterior cruciate ligament (ACL) injuries are highly debated, yet the incidence rate of ACL injury continues to increase. Measures of movement quality may be an effective method for identifying individuals who are at a high risk of injury.

Purpose: The purpose of this study was to investigate whether a movement screen and/or a drop-jump landing (DJL) task identifies female individuals at a higher risk for sustaining non-contact lower extremity (LE) injuries, particularly ACL injuries.

Study design: Cohort study.

Methods: 187 women (mean age 19.5 ± 1.21 years) who played collegiate soccer, volleyball, or basketball completed the Functional Movement Screen (FMS™) and a drop-jump landing task. Weekly injury reports of participants who sustained a non-contact LE injury were collected. FMS™ scores (both total score and individual screens) and Knee Abduction Moment (KAM) values from the DJL task, were compared between injured and uninjured sample populations.

Results: A statistically significant difference (t = 1.98, p = 0.049) was observed in the FMS™ scores between the injured (ACL and LE injury) and uninjured groups. Prior ACL injury was also a significant predictor of LE injury (OR = 4.4, p = 0.01).

Conclusions: The FMS™ can be used to identify collegiate female athletes who are at an increased risk of sustaining a non-contact ACL or LE injury. Female collegiate athletes that score 14 or less on the FMS™ have a greater chance of sustaining a non-contact LE injury than those who score above 14.

Level of evidence: 3b.

Keywords: anterior cruciate ligament; functional movement screen; knee abduction moment.

Figures

Figure 1.

Wooden box jump Wooden box used to perform drop jump landing (DJL) task. The box was built to match the specifications suggested by Myer et al; 31 cm high. Tape was added so that the participants’ feet were separated 35 cm apart while standing on the box.

Figure 2.

Knee flexion angle 1 The frame rate prior to initial contact with the ground was used to identify the position of knee flexion angle 1 (F1). The knee flexion range of motion (ROM) value was determined by subtracting F2 from F1 (F1-F2 = knee flexion ROM value). The knee flexion value was used in the KAM (Knee Abduction Moment) nomogram to determine each participant's probability of demonstrating high KAM (21.74 Nm) during the drop jump landing task.

Figure 3.

Knee flexion angle 2 The frame rate with maximum knee flexion was used to identify the position of knee flexion angle 2 (F2). The knee flexion range of motion (ROM) value was determined by subtracting F2 from F1 (F1-F2 = knee flexion ROM value). The knee flexion value was used in the KAM (Knee Abduction Moment) nomogram to determine each participant's probability of demonstrating high KAM (21.74 Nm) during the drop jump landing task.

Figure 4.

Knee valgus position 1 The frame rate prior to initial contact with the ground was used to identify the position of knee joint center for knee valgus position 1 (V1). Knee valgus motion value was determined by subtracting V2 from V1 (V1-V2 = knee valgus motion value). The knee valgus motion value was used in the KAM (Knee Abduction Moment) nomogram to determine each participant's probability of demonstrating high KAM (21.74 Nm) during the drop jump landing task.

Figure 5.

Knee valgus position 2 The frame rate with maximal medial position of knee joint center was used to identify the position for knee valgus position 2 (V2). Knee valgus motion value was determined by subtracting V2 from V1 (V1-V2 = knee valgus motion value). The knee valgus motion value was used in the KAM (Knee Abduction Moment) nomogram to determine each participant's probability of demonstrating high KAM (21.74 Nm) during the drop jump landing task.