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Trunk and lower extremity long-axis rotation exercise improves forward single leg jump landing neuromuscular control
Nyland J, Krupp R, Givens J, Caborn D
Physiotherapy Theory and Practice 2022 Nov;38(13):2689-2701
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Anterior cruciate ligament (ACL) injuries often involve sudden single leg loading with directional changes. Trunk and lower extremity (LE) load transfer and muscle power are directly coupled during these movements. The effect of trunk and LE long-axis rotation training on forward single leg drop jump landing and stabilization (FSLDJLS) was studied. Using block randomization (gender), 36 (18 men, 18 women) subjects were assigned to experimental (nine, 20 min exercise sessions) and control groups with equal subject number. Ground reaction force (1000 Hz), kinematic (60 Hz) and LE EMG (1000 Hz) data were synchronously collected. Statistical analysis compared pre- and post-test neuromuscular control mean change differences (MCD), and hip flexion-LE peak EMG % maximum volitional isometric contraction (%MVIC) (expressed as decimal equivalents), mean change difference (MCD) relationships. The experimental group had greater landing knee flexion (3.5 +/- 3.6 degrees versus -0.4 +/- 3.3 degrees, p = 0.002) MCD, greater dynamic LE stiffness after landing (0.09 +/- 0.14 versus -0.11 +/- 0.14, p = 0.001) MCD, and increased gluteus maximus (GMAX) (0.20 +/- 0.39%MVIC versus -0.23 +/- 0.46%MVIC, p = 0.006) and gluteus medius (GMED) EMG amplitude (0.22 +/- 0.31 versus -0.07 +/- 0.36%MVIC, p = 0.018) MCD. This group also had decreased GMAX (-166.5 +/- 403.6 ms versus 89.3 +/- 196 ms, p = 0.025), GMED (-75.9 +/- 126.8 ms versus 131.2 +/- 207.1 ms, p = 0.002) and vastus lateralis (-109.1 +/- 365 ms versus 205.5 versus 510 ms, p = 0.04) activation duration MCD. More experimental group subjects had increased landing knee flexion MCD (15/18 versus 8/18, p = 0.015), increased dynamic LE stiffness MCD (15/18 versus 2/18, p < 0.0001) and increased GMAX (15/18 versus 7/18, p = 0.006) and GMED (17/18 versus 10/18, p = 0.007) EMG amplitude MCD, and reduced GMAX (12/18 versus 6/18, p = 0.046), GMED (11/18 versus 5/18, p = 0.044), rectus femoris (12/18 versus 6/18, p = 0.046), and vastus lateralis (13/18 versus 7/18, p = 0.044) EMG activation duration MCD. Only the experimental group displayed significant relationships between landing and peak hip flexion and peak LE EMG amplitude MCD. Increased dynamic LE stiffness, increased hip muscle EMG amplitude and decreased hip and knee muscle activation duration MCD in the experimental group suggests improved LE neuromuscular control.

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