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Physiotherapy Theory and Practice
An International Journal of Physical Therapy
Volume 38, 2022 - Issue 13
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Research Report

Trunk and lower extremity long-axis rotation exercise improves forward single leg jump landing neuromuscular control

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Pages 2689-2701 | Received 30 Jun 2020, Accepted 28 Aug 2021, Published online: 03 Oct 2021
 

ABSTRACT

Background

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.

Methods

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.

Results

The experimental group had greater landing knee flexion (3.5 ± 3.6° vs. −0.4 ± 3.3°, p = .002) MCD, greater dynamic LE stiffness after landing (0.09 ± 0.14 vs. −0.11 ± 0.14, p = .001) MCD, and increased gluteus maximus (GMAX) (0.20 ± 0.39%MVIC vs. −0.23 ± 0.46%MVIC, p = .006) and gluteus medius (GMED) EMG amplitude (0.22 ± 0.31 vs. −0.07 ± 0.36%MVIC, p = .018) MCD. This group also had decreased GMAX (−166.5 ± 403.6 ms vs. 89.3 ± 196 ms, p = .025), GMED (−75.9 ± 126.8 ms vs. 131.2 ± 207.1 ms, p = .002) and vastus lateralis (−109.1 ± 365 ms vs. 205.5 vs. 510 ms, p = .04) activation duration MCD. More experimental group subjects had increased landing knee flexion MCD (15/18 vs. 8/18, p = .015), increased dynamic LE stiffness MCD (15/18 vs. 2/18, p < .0001) and increased GMAX (15/18 vs. 7/18, p = .006) and GMED (17/18 vs. 10/18, p = .007) EMG amplitude MCD, and reduced GMAX (12/18 vs. 6/18, p = .046), GMED (11/18 vs. 5/18, p = .044), rectus femoris (12/18 vs. 6/18, p = .046), and vastus lateralis (13/18 vs. 7/18, p = .044) EMG activation duration MCD. Only the experimental group displayed significant relationships between landing and peak hip flexion and peak LE EMG amplitude MCD.

Conclusion

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.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Fischer Owen Grant, Norton Healthcare.

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