The Effect of Dynamic Neuromuscular Stability (DNS) Exercises on Knee Functional ‎Tests in Female Athletes

Document Type : Original Article

Authors

1 Physical Education and Sports Sciences (Sports Injuries and Corrective Exercises), Faculty of Physical Education and Sports Sciences, Gilan University, Rasht, Iran

2 Department of Physiotherapy, Faculty of Medicine, Gilan University of Medical Sciences, ‎Rasht, Iran

3 Department of Physical Education and Sports Sciences, Faculty of Physical Education and ‎Sports Sciences, Gilan University, Rasht, Iran

Abstract

Purpose:
Strengthening and improving neuromuscular control in various ways, including technique modification, in order to prevent sports injuries, as a principle, is always of interest to researchers and athletes. Landing technique after jumping during sports such as volleyball is known as one of the most important non-contact mechanisms of knee joint ligament injury. The purpose of this study was to investigate the effect of dynamic neuromuscular stability (DNS) exercises on knee functional tests in female athletes.
Methods:
30 female volleyball players (age 22.06±3.39 years, height 1.67±0.04 m, weight 63.70±8.86 kg and body mass index 22.81±3.38 kg/m2) with at least three years of experience in volleyball training, they participated in this research and were randomly divided into two control groups (15 people) and an experimental group (15 people). Tuck Jump and Landing Error Scoring System (LESS) tests were recorded as subjects' performance scores. The kinematic variables of the subjects' lower limbs were measured by two cameras from the sagittal and frontal views during the Tuck Jump and LESS tests, before and after DNS exercises. The functional error of the subjects was recorded using the Kinovea software and recorded in the special table for scoring the tests. The subjects of the experimental group participated in the program of DNS exercises for 6 weeks and 3 sessions per week (each session lasting about 50 minutes). In order to analyze the data, independent and dependent parametric t-tests were used for data with normal distribution, and Mann Whitney U and Wilcoxon non-parametric tests were used for data with non-normal distribution in SPSS version 23 software.
Results:
The findings of the current research showed that DNS exercises was led to a significant decrease in the average Tuck Jump errors from 10.66 in the pre-test to 7.80 in the post-test (p=0.001), the score of the LESS from 8.13 in the pre-test to 4.53 in the post-test (p=-0.001) and the ligament dominance score decreased from 1.40 in the pre-test to 0.8 in the post-test (p=0.003) in the experimental group.
Conclusion:
According to the results of the present study, it seems that performing DNS exercises in female volleyball players reduces the risk of injury and improves Motor-performance and is probably effective in the rehabilitation of athletes. Therefore, the use of DNS exercises in sports with frequent jumps and landings such as volleyball is recommended to prevent ACL injury.

Keywords

References

  1. Letafatkar A, Rajabi R, Tekamejani EE, Minoonejad H. Effects of perturbation training on knee flexion angle and quadriceps to hamstring cocontraction of female athletes with quadriceps dominance deficit: Pre–post intervention study. Knee 2015; 22(3): 230-236.
  2. Buckwalter JA, Einhorn TA, Simon SR. Orthopaedic basic science: biology and biomechanics of the musculoskeletal system. Orthopaedic Basic Science: biology and biomechanics of the musculoskeletal system. Rosemont; American Academy of Orthopaedic Surgeons 2000; 2 ed; 450-490.
  3. Shultz SJ, Sander T, Kirk S, Perrin D. Sex differences in knee joint laxity change across the female menstrual cycle. J Sports Med Phys Fitness 2005; 45(4): 594-603.
  4. Callaghan JJ. The Adult Knee. Philadelphia: Lippincott Williams & Wilkins 2003; 1 ed; 663-706.
  5. Boden BP, Dean GS, Feagin JA, Garrett WE. Mechanisms of anterior cruciate ligament injury. Orthopedics 2000; 23(6): 573-578.
  6. Blanchard S. Anatomy For Problem Solving In Sports Medicine: Knee 2016; 1 ed; p 95-120.
  7. Kobesova A, Davidek P, Morris CE, Andel R, , et al. Functional postural-stabilization tests according to Dynamic Neuromuscular Stabilization approach: Proposal of novel examination protocol. J Bodyw Mov Ther 2020; 24(3): 84-95.
  8. Pantano KJ, White SC, Gilchrist LA, Leddy J. Differences in peak knee valgus angles between individuals with high and low Q-angles during a single limb squat. Clin Biomech 2005; 20(9): 966-972.
  9. Dodds JA, Arnoczky SP. Anatomy of the anterior cruciate ligament: a blueprint for repair and reconstruction. Arthroscopy 1994; 10(2): 132-139.
  10. Frank C, Kobesova A, Kolar P. Dynamic neuromuscular stabilization & sports rehabilitation. Int J Sports Phys Ther 2013; 8(1): 62-73.
  11. Sasaki S, Tsuda E, Yamamoto Y, Maeda S, Kimura Y, Fujita Y, et al. Core-muscle training and neuromuscular control of the lower limb and trunk. J Athl Train 2019; 54(9): 959-969.
  12. Hewett TE, Myer GD. Reducing knee and anterior cruciate ligament injuries among female athletes–a systematic review of neuromuscular training interventions. J Knee Surg. 2005; 18(01): 82-88.
  13. Hewett TE, Johnson DL. ACL prevention programs: fact or fiction? Orthopedics 2010; 33(1): 36-39.
  14. Padua DA, Marshall SW, Boling MC, Thigpen CA, et al. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics: the JUMP-ACL study. The Am J Sports Med 2009; 37(10): 1996-2002.
  15. Ashkezari MHK, Sahebozamani M, Daneshjoo A, Bafghi HA. Comparison of the Effect of 6 Weeks of Balancing and Hopping Strengthening Training on the Kinematics of the Lower Extremities of Athletes with Functional Ankle Instability while Running: A Randomized Controlled Trial. Journal of Shahid Sadoughi University of Medical Sciences. 2020; 28(7): 2854-2866.
  16. Hamoongard M, Hadadnezhad M, Abbasi A. Effect of combining eight weeks of neuromuscular training with dual cognitive tasks on landing mechanics in futsal players with knee ligament dominance defect: a randomized controlled trial. BMC Sports Sci Med Rehabil 2022; 14(1): 196.
  17. Wilczyński B, Wąż P, Zorena K. Impact of three strengthening exercises on dynamic knee valgus and balance with poor knee control among young football players: A randomized controlled trial. Healthcare 2021; 9(5): 558.
  18. Sonesson S, Hägglund M, Kvist J, Torvaldsson K, et al. Neuromuscular control and hop performance in youth and adult male and female football players. Phy Ther Sport 2022; 55: 189-195.
  19. Kalantariyan M, Rajabi R. The effect of TRX Preventive Exercises on some Tests for Predicting Lower Extremity Injury in Athlete’, s Students Prone to Injury. Journal of Safety Promotion and Injury Prevention 2021; 9(3): 190-200. [Persian]
  20. Zareei M, Rahmani N, Ghorbani A. The Effect of FIFA 11+ KIDS on the Jump-Landing Biomechanics of Adolescent Soccer Players. Journal of Applied Exercise Physiology 2018; 14(27): 195-207. [Persian]
  21. Herman DC, Pritchard KA, Cosby NL, Selkow NM. Effect of strength training on jump-landing biomechanics in adolescent females. Sports Health 2022; 14(1): 69-76.
  22. Read PJ, Oliver JL, Dobbs IJ, Wong MA, et al. The effects of a four-week neuromuscular training program on landing kinematics in pre-and post-peak height velocity male athletes. J Science Sport Exerc. 2021; 3: 37-46.
  23. Fort-Vanmeerhaeghe A, Benet A, Mirada S, Montalvo AM, Myer GD. Sex and maturation differences in performance of functional jumping and landing deficits in youth athletes. J Sport Rehabil 2019; 28(6): 606-613.
  24. Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE. Treatment of anterior cruciate ligament injuries, part I. Am J Sports Med 2005; 33(10): 1579-1602.
  25. Gulan G, Matovinović D, Nemec B, Rubinić D, Ravlić-Gulan J. Femoral neck anteversion: values, development, measurement, common problems. Coll Antropol 2000; 24(2): 521-527.
  26. Daneshmandi H, Saki F, Daneshmandi L, Daneshmandi M. Lower extremity alignment in female athletes with ACL reconstruction. Medicina dello Sport 2012; 65(2): 211-221.
  27. Hertel J, Dorfman JH, Braham RA. Lower extremity malalignments and anterior cruciate ligament injury history. J Sports Sci Med 2004; 3(4): 220-225.
  28. Nguyen A-D, Boling MC, Levine B, Shultz SJ. Relationships between lower extremity alignment and the quadriceps angle. Clinj Sport Med 2009; 19(3): 201-206.
  29. Shultz SJ, Levine BJ, Nguyen AD, Kim H, et al. A comparison of cyclic variations in anterior knee laxity, genu recurvatum, and general joint laxity across the menstrual cycle. J Orthop Res 2010; 28(11): 1411-1417.
  30. Loudon JK, Goist HL, Loudon KL. Genu recurvatum syndrome. J Orthop Sports Phys Ther 1998; 27(5): 361-367.
  31. Hewett TE, Ford KR, Hoogenboom BJ, Myer GD. Understanding and preventing acl injuries: current biomechanical and epidemiologic considerations-update 2010. N Am J Sports Phys Ther 2010; 5(4): 234-251.
  32. Huegel M, Meister K. The influence of lower extremity alignment in the female population on the incidence of noncontact ACL injuries. AOSSM Proc Manual 1997; 23: 790.
  33. Vaeyens R, Lenoir M, Williams AM, Philippaerts RM. Talent identification and development programmes in sport: current models and future directions. Sports med 2008; 38: 703-714.
  34. Quatman CE, Quatman-Yates CC, Hewett TE. A ‘plane’explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports Med 2010; 40(9): 729-746.
  35. Withrow TJ, Huston LJ, Wojtys EM, Ashton-Miller JA. The relationship between quadriceps muscle force, knee flexion, and anterior cruciate ligament strain in an in vitro simulated jump landing. Am J Sports Med 2006; 34(2): 269-274.
  36. Hopper AJ, Haff EE, Joyce C, Lloyd RS, Haff GG. Neuromuscular training improves lower extremity biomechanics associated with knee injury during landing in 11–13 year old female netball athletes: A randomized control study. Front physiol 2017; 883.
Journal of Paramedical Sciences & Rehabilitation
Volume 13, Issue 2
July 2024
Pages 51-62

Files

Share

How to cite

Statistics