Detection of Neuromuscular Deficits in Uninjured Youth Basketball Players

Study Overview
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Brief Summary
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Basketball is an impact, coordination-opposition sport with continuous contact among players and it is considered a sport of medium-high injury incidence. Players are force to have a physical condition appropriate to their practice and the demand to which they must respond due to the intensity of the efforts this sport requires. In order to achieve this, it is necessary to establish an evaluation protocol that allows the detection of functional deficiencies, to guide and conduct in a specific and early way every moment of players' health and growth. The purpose of this study is to evaluate and detect federated youth basketball players' (U12 - U17) neuromuscular deficiencies in mobility, stability and landing technique in static and dynamic situations to simulate all the most important actions of basketball demands.

Detailed Description
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It is intended that the specific detection and individualized approach to neuromuscular deficiencies will decrease the prevalence of injuries and accidents and therefore, the performance of training basketball players will be improved. The purpose of this study was to evaluate and detect federated youth basketball players' (under 12 years until under 17 years) neuromuscular deficits in mobility, stability and landing technique in static and dynamic situations similar to simulate the most important actions of basketball demands. This cross-sectional study was conducted from October 2018 to May 2019. A total of 778 basketball players were selected for the present study. In order to evaluate this specific tests and trials will be carried out on different teams from various clubs in the categories from under 12 years (U12) to under 17 (U17), both male and female. The evaluations will consist of a static physical measures and a dynamic one. These will be conducted throughout the season. Inclusion criteria were: age > 12 years and <18 years at testing, and to be actively competing during the study. Subjects were excluded if they had suffered any injury in lower limbs before the screening; presented any injury (overuse or acute) at the time of testing or if they suffered any oncological, psychological and/or psychiatric illnesses, or if they did not attend on the day of the assessment. The main outcomes were ankle joint dorsiflexion was analyzed with Weight-bearing Dorsiflexion Test; monopodial ankle stability was analyzed with Single Leg Balance Test. Dynamic lower extremity valgus was analyzed with Single Leg Squat Test, Modified Tuck Jump Test, Single Leg Squat Test and Hurdle Step Test were used to evaluate also Lumbopelvic stability and dynamic postural control. Neuromuscular deficits during continuous tuck jumps, landing technique flaws and Plyometric Technique were analyzed with Modified Tuck Jump Test. All these tests are scientifically validated for this purpose. All players were familiar with the procedures of all test before. Testing was performed in the same day, in the same order, at the same time of the day (18:00-20:00).

Official Title
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Detection of Neuromuscular Deficits in Movement Pattern in Uninjured Federated Youth Basketball Players: a Cross-sectional Study

Conditions
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Injury;Sports, Biomechanical Lesions, Musculoskeletal Injury

Intervention / Treatment
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* Other: Basketball Injury Defense


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 12 years and <18 years at testing. To be actively competing during the study. Exclusion Criteria: Had suffered any injury in lower limbs before the screening. Presented any injury (overuse or acute) at the time of testing. Psychological or psychiatric diseases diagnosed. Oncological diseases diagnosed. Did not attend on the day of the assessment.

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Youth basketball players who belonged to basketball developmental teams (U12, U14,U16,U17).<br>All participants completed the same ten-minute neuromuscular warm-up consisting of the following exercises: joint mobility exercises, dynamic stretching exercises, jumps, multidirectional displacements and changes of direction. Following, subjects were allowed three practice trials for each test. Consistent feedback was provided throughout to ensure proper technique. The performance of each test was recorded using two cameras (Iphone XS, Apple). To allow visible tracking of the different joints, participants were required to wear shorts with the hem at approximately mid-thigh. When scoring performance, each test was viewed in both planes (sagittal and frontal views). | Other: Basketball Injury Defense<br>* To establish a specific evaluation protocol for youth basketball players.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ankle joint dorsiflexion | Weight-bearing dorsiflexion test. Ankle dorsiflexion was evaluated through the LegMotion system (LegMotion, your Motion®, Albacete, Spain). Each player started with their hands on their hips, and put the assigned foot on the middle of the longitudinal line just behind the transversal line on the platform. The alternate foot was positioned off the platform with toes at the edge of the platform. Each trial consisted of flexing the ankle as much as possible without raising the heel of the assessed ankle trying to touch a marker, situated just behind the patella, with their knee. The distance achieved was recorded in centimeters. Three trials were allowed with each ankle (i.e., left and right) with 10 seconds of passive recovery between trials. The third value in each ankle was used in subsequent analysis of weight-bearing dorsiflexion. | Through study completion, an average of 1 year | 
| Ankle stability | Single Leg Balance Test. It was considered stable if the foot remained in neutral position during movement. However, if excessive pronation of the foot was evident during movement or external rotation of the leg/foot it was scored as unstable. | Through study completion, an average of 1 year | 
| Dynamic lower extremity valgus | Single Leg Squat Test. An aligned knee-ankle position was considered when the patella was aligned with the second toe. Five consecutive attempts were performed with each limb, and the correct alignment between the knee and the second toe in loading was assessed to analyze an excess of knee valgus. | Through study completion, an average of 1 year | 
| Lumbopelvic stability | Single Leg Squat Test. It was considered stable if there was minimal movement in all three planes and the sacroiliac joints were aligned. On the other hand, it was considered unstable if the sacroiliac joints were not aligned in the frontal plane or if there was evidence of anteroposterior tilt or rotation in the sagittal plane as well as anterior trunk flexion or increased lumbar lordosis. | Through study completion, an average of 1 year | 
| Dynamic postural control | Hurdle Step Test. For this purpose, the deviation of the trunk with respect to the center of gravity was observed. A smaller displacement or deviation implied a better postural stability. | Through study completion, an average of 1 year | 
| Neuromuscular deficits during continuous tuck jumps | Modified Tuck Jump Test. Lower extremity valgus at landing, Thighs do not reach parallel (peak of jump), Thighs not equal side-to-side during flight | Through study completion, an average of 1 year | 
| Landing technique flaws | Modified Tuck Jump Test. Foot placement not shoulder width apart, Foot placement not parallel (front to back), Foot contact timing not equal (Asymmetrical landing), Excessive landing contact noise. | Through study completion, an average of 1 year | 
| Plyometric Technique | Modified Tuck Jump Test. Pause between jumps, Technique declines prior 10 seconds, Does not land in same foot print (Consistent point of landing) | Through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Age | Years | Through study completion, an average of 1 year | 
| Age categories | Under 12, Under 14, Under 16 or Under 17 | Through study completion, an average of 1 year | 
| Body Mass Index (BMI) | kg/m2 | Through study completion, an average of 1 year | 
| Generalized hipermobility | The presence of hypermobile confirmed by Beighton's criteria. Considering hypermobile as those who obtained a score of > 7 points out of a total of 9 points | Through study completion, an average of 1 year | 
| Gender | Female or male | Through study completion, an average of 1 year | 
| Weight | Kilograms | Through study completion, an average of 1 year | 
| Height | Centimeters | Through study completion, an average of 1 year | 
| Wingspan | Centimeters | Through study completion, an average of 1 year | 
| Lower limb dominance | Dominant leg / non dominant leg | Through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Basketball, Physical Therapy, Youth athletes