Influence of Proprioceptive Reweighting Ability on Lower-limb Biomechanics During Functional Tasks
Condition: Anterior Cruciate Ligament Injuries
MeSH terms: Anterior Cruciate Ligament Injuries
Study type: Interventional

Summary: 
      Anterior cruciate ligament (ACL) injuries are frequent in handball especially among young
      players. Recent investigations highlighted the implication of the central nervous system as a
      potential risk factor for ACL rupture.

      The ability to dynamically reweight proprioceptive signals according to postural conditions
      is crucial for balance control.

      The aim of this study is therefore to investigate the influence of proprioceptive reweighting
      on biomechanical determinants of ACL loads during functional tasks and unplanned side cutting
      manoeuvers.
    

Detailed description: 
      Team Handball is a traumatic sport, especially regarding anterior cruciate ligament (ACL)
      injuries. Young females are more vulnerable as they are 3 to 5 times more likely to sustain
      an ACL rupture compare to males.

      Several anatomical, biomechanical and sensorimotor risk factors have been clearly identified,
      however the implication of the central nervous system was recently highlighted. Indeed, it
      has been shown that individuals who will suffer of ACL ruptures exhibited a decreased
      functional connectivity between brain regions responsible for postural control and
      sensorimotor processing. Due to the unanticipated situations that occurred during game
      situations, the role of the brain (i.e neural control) is now advocated to explain
      sensorimotor errors leading to injuries during complex tasks such as faking an opponent.
      Muscle vibration is a reliable tool to assess proprioceptive integration during postural
      control. The ability to shift from one proprioceptive cue to another when postural conditions
      are changing is crucial. This dynamic reweighting process allow to obtain an optimal postural
      control. However, recent investigations revealed that this process is altered among
      symptomatic populations, elderly patients or even under fatigue conditions. More precisely,
      some individuals seem able to shift proprioceptive reliance while other doesn't. To our
      knowledge, no studies have investigated the link between proprioceptive reweighting and
      biomechanical determinants of ACL loads during functional tasks. Thus, the aim of this study
      is to compare lower-limb biomechanics during unanticipated side cutting manoeuvres and single
      leg drop vertical jump among young handball players according to their ability to reweight
      proprioceptive signals.
    

Intervention name(s): Star Excursion Balance Test; Single leg Drop Vertical Jump; Unplanned sidestep cutting manoeuvre; Tendon vibration
Intervention type(s): Other; Other; Other; Other
Intervention description(s): The subject will be in unipodal support (only one foot on the ground) on the tested lower limb in the center of the platform. Three lines forming a "Y" will be arranged according to the lower limb in charge in three directions : anterior (ANT), posteromedial (PM) and posterolateral (PL). The goal is then to reach the longest distance possible in all three directions with the tip of the foot in relief before returning to the starting position. The subject will have 4 training trials per direction on each lower limb then 3 trials will be recorded in order to keep the average.; The subject will drop from a step and land on one leg, then jump as high as possible and stabilize again on the same leg. The height of the step is 30 cm. The subject will perform 3 consecutive jumps in the strictest respect of the instructions: drop to the level of the mark on the ground and bounce as high as possible while spending a minimum of time on the ground. The subject must stabilize for 3 seconds during the second contact with the ground so that the instructions and measurements are reproducible.; The objective is to create an unanticipated playing situation, close to the daily actions of the subjects in the practice of handball. The subject will make sidestep cutting manœuvre in front of an opponent simulated by a dummy used during usual training.
The subject will sprint in a straight line and then at the force platform will make a rapid change of direction on the side of his shooting arm or will continue his run in a straight line. A light signal randomly will indicate to the player the direction in which he must carry out his manoeuvre. A computer reconstruction of the kinematics and dynamics (knee moment) will be performed.; The subject will be asked to stand, motionless in bipodal (both feet on the ground) support on a stable and unstable ground (foam). A tendon vibration (80Hz) will be randomly applied to the subject in the Achilles tendons or paravertebral muscles. This vibration will cause an alteration of proprioceptive information in the vibrated area leading to a disruption of postural balance. Thus, according to the amount of displacement of the center of pressure (CoP), the proprioceptive weighting ratio (dRPW) is calculated to deduce therefrom the weight assigned by the CNS to the various proprioceptive inputs during the postural task.
Other intervention name(s): SEBT; SDVJ; Unplanned change of direction
Intervention model: Single Group Assignment
Intervention model description: Mono-centric comparative cross-sectional observational study with minimal risks and constraints.
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: proprioceptive reweighting ability; sidestep cutting manoeuvre; handball