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Influence of Proprioceptive Reweighting Ability on Lower-limb Biomechanics During Functional Tasks

Not Applicable
Completed
Conditions
Anterior Cruciate Ligament Injuries
Interventions
Other: Star Excursion Balance Test
Other: Single leg Drop Vertical Jump
Other: Unplanned sidestep cutting manoeuvre
Other: Tendon vibration
Registration Number
NCT04736511
Lead Sponsor
University Hospital, Brest
Brief Summary

Anterior cruciate ligament (ACL) injuries are frequent in handball especially among young players. Recent investigations highlighted the implication of the central nervous system as a potential risk factor for ACL rupture.

The ability to dynamically reweight proprioceptive signals according to postural conditions is crucial for balance control.

The aim of this study is therefore to investigate the influence of proprioceptive reweighting on biomechanical determinants of ACL loads during functional tasks and unplanned side cutting manoeuvers.

Detailed Description

Team Handball is a traumatic sport, especially regarding anterior cruciate ligament (ACL) injuries. Young females are more vulnerable as they are 3 to 5 times more likely to sustain an ACL rupture compare to males.

Several anatomical, biomechanical and sensorimotor risk factors have been clearly identified, however the implication of the central nervous system was recently highlighted. Indeed, it has been shown that individuals who will suffer of ACL ruptures exhibited a decreased functional connectivity between brain regions responsible for postural control and sensorimotor processing. Due to the unanticipated situations that occurred during game situations, the role of the brain (i.e neural control) is now advocated to explain sensorimotor errors leading to injuries during complex tasks such as faking an opponent. Muscle vibration is a reliable tool to assess proprioceptive integration during postural control. The ability to shift from one proprioceptive cue to another when postural conditions are changing is crucial. This dynamic reweighting process allow to obtain an optimal postural control. However, recent investigations revealed that this process is altered among symptomatic populations, elderly patients or even under fatigue conditions. More precisely, some individuals seem able to shift proprioceptive reliance while other doesn't. To our knowledge, no studies have investigated the link between proprioceptive reweighting and biomechanical determinants of ACL loads during functional tasks. Thus, the aim of this study is to compare lower-limb biomechanics during unanticipated side cutting manoeuvres and single leg drop vertical jump among young handball players according to their ability to reweight proprioceptive signals.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
41
Inclusion Criteria
  • Aged from 15 to 25 years
  • Intensive training handball practice for at least two years, mastering the technical gesture of unplanned sidestep cutting manoeuvre
  • Training volume of 5 hours minimum per week
  • Signature of the consent (participants and parents for minors)
Exclusion Criteria
  • Recent osteoarticular pathology (i.e. less than three months) of the lower limbs, whether traumatic or not
  • Unfit to consent or refusal to participate in the study
  • Obvious standing balance disorder or disabling neurological pathology
  • Pain of the musculoskeletal system (joint, tendon or muscle) permanent or during exercise
  • Fatigue (evaluation using the Borg scale) during the clinical examination (> 6) prior to performing the sporting gesture
  • Known skin allergy to any adhesive product

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Healthy volunteersUnplanned sidestep cutting manoeuvreHandball players
Healthy volunteersSingle leg Drop Vertical JumpHandball players
Healthy volunteersStar Excursion Balance TestHandball players
Healthy volunteersTendon vibrationHandball players
Primary Outcome Measures
NameTimeMethod
Knee abduction moment (quantitative measure) during unplanned sidestep cutting manœuvre.Inclusion

The measurement will be the average of the maximum knee abduction moments when the lower extremity is supported on the pushing leg, over the 5 tests carried out with a sidestep cutting manœuvre.

Secondary Outcome Measures
NameTimeMethod
Star Excursion Balance Test performance.Inclusion

The value obtained (in centimeters or relative to the length of the lower limb) reflects the dynamic postural performance of the lower limb under load without specificity of a particular joint of the lower limb. The subject will have 4 training trials per direction on each lower limb then 3 trials will be recorded in order to keep the average.

Angles of ankles, knees, hips, orientation of the pelvis during changes of direction.Inclusion

The angles, in degrees, of ankles, knees, hips and orientation of the pelvis during changes of direction will be determined during the unplanned sidestep cutting manœuvre test by computer reconstruction. The values will allow to compare biomechanicals characteristics according to the proprioceptive profile (plastic subjects vs rigid subjects).

Knee abduction moment when landing jumps in the Single leg Drop Vertical Jump.Inclusion

The measurement will be made on the average of the abduction moments of the knee when landing the jump on the ground.

The subject will perform 3 consecutive jumps in the strictest respect of the instructions.

Percentage of subjects with a proprioceptive plastic profile.Inclusion

A dRPW of 1 indicates 100% use of information from the ankle, while a dRPW of 0 indicates 100% use of information from the hip. It is thus possible to calculate an evolution of this dRPW during the passage from a stable to unstable soil. The "plastic" subjects decreases their dRPW on unstable ground (compared to stable) ("normal" behavior). "Rigid" subjects maintain (or even increase) their dRPW when passing over unstable ground.

Trial Locations

Locations (1)

CHRU Brest

🇫🇷

Brest, France

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