physioscience , Thieme Verlag Heft 3-2023, Jahrgang 19) ISSN 1860-3351 Seite(n) 116 bis 123 DOI: 10.1055/a-1963-6545 CareLit-Dokument-Nr: 318600 |
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Zusammenfassung Hintergrund Im Sport wird angenommen, dass ein dynamischer Knievalgus bei einbeinigen Landungen einen relevanten Verletzungsmechanismus des vorderen Kreuzbands darstellt. Während bestehende effektive Präventionsprogramme zur Reduktion des Knievalgus primär auf die Verbesserung allgemeiner konditioneller und/oder koordinativer Einflussgrößen ausgerichtet sind, fokussiert ein Video-Feedback-Training die Korrektur individueller Defizite in der sportlichen Technik, um u.âa. ein potenzielles Verletzungsrisiko zu reduzieren. Ziel Evaluation der kurz- und insbesondere mittel- und langfristigen Wirksamkeit eines Video-Feedback-Trainings zur Veränderung des frontalen Kniewinkels bei einbeinigen Landungen. Methode Im Rahmen einer exploratorischen Studie wurden 10 sportlich aktive Personen (Alter: 25â±â5 Jahre, Größe: 170,8â±â4,5âcm) getestet. Diese führten in Anlehnung an das Landing Error Scoring System (LESS-Test) einbeinige Drop-Jumps in einem Pretest, in einer Aneignungsphase mit Video-Feedback und 2 Retentionstests 2 und 6 Wochen nach der Aneignungsphase ohne Video-Feedback aus. Das Video-Feedback wurde in der Aneignungsphase bei jedem zweiten Sprung und zusätzlich selbstbestimmt auf Nachfrage über ein Expertenmodell mit neutraler Kniestellung im Overlay-Modus aus der Frontalperspektive gegeben. Ergebnisse Die Ergebnisse wurden nach Sprung- und Nichtsprungbein der Proband*innen differenziert. Sie zeigen eine bedeutsame Verringerung des frontalen Kniewinkels für das Sprungbein (F1, 9â=â10,43, pâ=â0,01, η2 pâ=â0,54, 95â% CI [0,04; 0,74]) bei einbeinigen Landungen in der Aneignungsphase, jedoch keine statistisch bedeutsame Verringerung für das Nichtsprungbein (F1, 9â=â4,07, pâ=â0,08, η2 pâ=â0,31, 1-βâ=â0,44). Im Retentionstest nach 6 Wochen nähert sich der frontale Kniewinkel beidseitig dem Ausgangsniveau aus dem Pretest wieder an. Schlussfolgerung Ein Video-Feedback-Training bietet sich als einfach durchzuführendes, alternatives Verletzungspräventionsprogramm an. Eine fehlende mittel- und langfristige Veränderung und hohe Variabilität des frontalen Kniewinkels lassen eine mehrfache und/oder regelmäßige Durchführung eines Video-Feedback-Trainings sinnvoll erscheinen. In weiteren Studien mit Kontrollgruppendesign und unterschiedlichen Feedback-Prozeduren wird systematisch zu prüfen sein, ob eine längerfristige Reduktion eines potenziellen Verletzungsrisikos des vorderen Kreuzbands erreicht werden kann. Abstract Background In sports, it is assumed that dynamic knee valgus is a relevant injury mechanism for the anterior cruciate ligament. Existing and effective injury prevention programmes for reduction of dynamic knee valgus primarily focus on improvement of general conditioning and/or coordination, while video feedback training focuses on improvement of deficits in technique to, among other, decrease potential injury risk. Aim Evaluation of short, mid and long-term effectiveness of video-feedback training for adjustment of frontal knee angle in single-leg landings. Method In an exploratory study, Nâ=â10 physically active subjects (age:25â±â5 years; body height: 170.8â±â4.5âcm) were tested. In line with the Landing Error Scoring System (LESS test), they carried out single-leg drop jumps in a pre-test, during an acquisition phase in which they were provided video feedback, as well as in 2 retention tests 2 and 6 weeks after the acquisition phase without video feedback. During the acquisition phase, video feedback was provided through an overlay of an expert model with a neutral frontal knee angle from the frontal perspective for every second drop jump and additionally, participants were able to claim self-determined video feedback. Results Data for the jumping leg and non-jumping leg were analysed separately. Results show a relevant reduction of frontal knee angle in the jumping leg (F1, 9â=â10.43, pâ=â.01, η2 pâ=â.54, 95â% CI [.04,.74]) but not for the non-jumping leg (F1, 9â=â4.07, pâ=â.08, η2 pâ=â.31, 1-βâ=â.44) during single-leg landings in the acquisition phase. The retention test after 6 weeks revealed that frontal knee angle in both legs approximated the initial knee position from the pre-test. Conclusion Video feedback training can be used as a feasible, alternative injury prevention programme. Missing mid and long-term adjustments and high variability in frontal knee angle suggest repeated and/or regular exposure to video feedback training. Future studies with control groups as well as different video feedback methods should systematically investigate whether a longer-term reduction of potentially anterior cruciate ligament injury risk is achievable. Schlüsselwörter Knievalgus - sportmotorisches Lernen - Präventivdiagnostik - LESS-Test - Drop-Jump Key words knee valgus - motor learning - prevention diagnostic - LESS test - drop jump Received: 29 September 2022 Accepted: 02 January 2023 06 April 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Literatur 1 Gokeler A, Zantop T, Jöllenbeck T. Epidemiologie. In: Gesellschaft für Orthopädisch-TraumatologischeSpoertmedizin, Hrsg. Vorderes Kreuzband – GOTS-Expertenmeeting;. 2010: 3-14 PubMedGoogle Scholar 2 Olsen O-E, Myklebust G, Engebretsen L. et al. Injury Mechanisms for Anterior Cruciate Ligament Injuries in Team Handball: A Systematic Video Analysis. Am J Sports Med 2004; 32: 1002-1012 DOI: 10.1177/0363546503261724. 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