Effect of Dynamic Taping on Landing Biomechanics in Athletes With Symptoms of Patellar Tendinopathy

National Yang Ming Chiao Tung University34 enrolled

Overview

Patellar tendinopathy (PT) is an overuse injury associated with loading activities, and popular among basketball and volleyball players. Although altered biomechanical characteristics during landing has been suggested as one of the risk factors for the development of PT, previous evidence failed to show the link between the sagittal plane biomechanics of the hip and knee joint and PT; and little was known about the frontal and horizontal plane biomechanics in athletes with PT. While other factors such as motor control or muscle activation also have not been explored fully. The purpose of this study is to compare hip motor control and biomechanical characteristics of the hip and knee joint during landing in athletes with and without symptomatic PT.

Background: Patellar tendinopathy is an overuse injury associated with loading activities, and it is thought to be caused by repetitive force applied to the patellar tendon. Patellar tendinopathy is popular among basketball and volleyball players, particularly in men. Although altered biomechanical characteristics during landing has been suggested as one of the risk factors for the development of patellar tendinopathy, previous evidence failed to show the link between the sagittal plane biomechanics of the hip and knee joint and patellar tendinopathy; and little was known about the frontal and horizontal plane biomechanics in athletes with patellar tendinopathy. Among those factors contributing to the biomechanical characteristics, hip and quadriceps strength were shown linked with the presence of patellar tendinopathy, while other factors such as motor control or muscle activation have not been explored fully. The purpose of this study is to compare hip motor control and biomechanical characteristics of the hip and knee joint during landing in athletes with and without symptomatic patellar tendinopathy. The investigators hypothesize that the athletes with symptomatic patellar tendinopathy have poorer motor control and different landing biomechanics as compared with asymptomatic athletes. Method: the investigators plan to recruit seventeen symptomatic patellar tendinopathy athletes for the experimental group, using demographic data (sex, age, height, weight, exercise type) of experimental group to match seventeen non-symptomatic athletes as control group. The assessment included hip motor control in various directions, and measurement of kinetics, kinematics and muscle activation during the step-down task, drop vertical jump and countermovement jump using the computer-aided video motion analysis system (Vicon) and the surface EMG (Noraxon). The group difference will be tested using t-test for the motor control ability and biomechanical characteristics. The significant level was set at 0.05.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 40 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * at the age of 18 to 40 years old * volleyball and basketball players have more than 2 years training experience * over 90 minutes of training time per week symptomatic group: * having patellar tendon pain during loading task last for 3 months * VISA-P questionnaire score ≦80 asymptomatic group: * without any lower extremity pain(NRS3/10) in past 3 months * VISA-P questionnaire score \>80 Exclusion Criteria: * Underwent sports physical therapy for knee pain in the past three months. * Currently have any other chronic or acute lower limb injuries with a pain score \>3/10. * Self-reported pregnancy. * Had surgery, fractures, or received steroid injections for the patellar tendon in the lower limbs. * with a history of rheumatoid arthritis, systematic and neurological diseases

Outcomes

Primary Outcomes

Hip Flexion Angles

Measure the hip joint angle when the knee reaches the maximum flexion angle during the landing phase of the countermovement jump

Time frame: In the experiment, the maximum knee flexion during the landing phase of the countermovement jump

Maximal Knee Flexion Angle

In the countermovement jump test, the force received by the force plate changes from 0 to a positive value during the landing phase. Measure the maximal knee flexion angle during this phase.

Time frame: The landing phase of the countermovement jump in the experiment

Hip Abduction Angle

Measure the hip abduction angle when the knee reaches the maximum flexion angle during the landing phase of the countermovement jump

Time frame: In the experiment, the maximum knee flexion during the landing phase of the countermovement jump

Knee Joint Flexion Angle

Perform the step-down test on a 15 cm high table to measure the knee flexion angle of the foot on the table when the side foot is at the lowest point.

Time frame: the contralateral foot is at its lowest point in step-down test in the experiment

Motor Control Ability

Having 4 motor control tests: Hip Flexion Control: Maintain an upright posture in a single-leg small knee bend. The knee aligns with the 2nd toe in the sagittal plane and \>5 cm beyond the toes. Internal/External Rotation Control:Perform a single-leg small knee bend while rotating the pelvis and upper body toward the opposite/same side. Rotate 35°/30° without excessive L/E compensation. Hip Adduction Control:Maintain a single-leg stance with symmetrical shoulders and pelvis. Pelvic lateral displacement \<10 cm, left-right displacement difference \<2 cm. Scoring Criteria: Avoid uncontrolled movements, perform isolated movements correctly, achieve adequate ROM, maintain normal breathing, control movements in eccentric/concentric phases, execute smoothly, stay relaxed and aware, ensure fluid transitions, avoid compensations, complete without feedback/support, and show no fatigue. Total score range: 0-52, converted to a percentage for comparison(0-100%).

Time frame: during the experiment, up to 4 hours

Secondary Outcomes

Maximum Muscle Activity of Biceps Femoris

Before the task, the subjects were asked to prone on the bed with their hips at 0 degrees and tested knee at 45 degrees of flexion, and to do isometric contractions with the utmost strength. The muscle contraction signals were recorded by EMG, and the average value of five measurements was taken as maximal voluntary contraction (MVC) of biceps femoris. The countermovement jump test requires the participant to cross their arms over the chest, squat down, and then jump as high as possible before landing. The landing phase is identified when the ground reaction force recorded by the force plate transitions from zero to a positive value. Using a trigger, the force plate data is synchronized with EMG data to determine the peak activation of the biceps femoris muscle during the landing phase. The biceps femoris contraction signals collected during the task were divided by the maximum biceps femoris contraction signal, and the results were standardized for comparison between individuals.

Time frame: Immediately during the experiment

Muscle Activity of Biceps Femoris

Before the task, the subjects were asked to prone on the bed with their hips at 0 degrees and tested knee at 45 degrees of flexion, and to do isometric contractions with the utmost strength. The muscle contraction signals were recorded by EMG, and the average value of five measurements was taken as maximal voluntary contraction (MVC) of biceps femoris. The countermovement jump test requires the participant to cross their arms over the chest, squat down, and then jump as high as possible before landing. The landing phase is identified when the GRF recorded by the force plate transitions from zero to a positive value. Using a trigger, the force plate data and kinematics data is synchronized with EMG data to determine the activation of the biceps femoris muscle during maximal knee flexion in the landing phase. The signals collected during the task were divided by the maximum biceps femoris contraction signal, and the results were standardized for comparison between individuals.