STUDY DESIGN:Cross-sectional. OBJECTIVE:To investigate predictors of increased frontal plane knee projection angle (FPKPA) in athletes. BACKGROUND:The underlying mechanisms that lead to increased FPKPA are likely multifactorial and depend on how the musculoskeletal system adapts to the possible interactions between its distal and proximal segments. Bivariate and linear analyses traditionally employed to analyze the occurrence of increased FPKPA are not sufficiently robust to capture complex relationships among predictors. The investigation of nonlinear interactions among biomechanical factors is necessary to further our understanding of the interdependence of lower-limb segments and resultant dynamic knee alignment. METHODS:The FPKPA was assessed in 101 athletes during a single-leg squat and in 72 athletes at the moment of landing from a jump. The investigated predictors were sex, hip abductor isometric torque, passive range of motion (ROM) of hip internal rotation (IR), and shank-forefoot alignment. Classification and regression trees were used to investigate nonlinear interactions among predictors and their influence on the occurrence of increased FPKPA. RESULTS:During single-leg squatting, the occurrence of high FPKPA was predicted by the interaction between hip abductor isometric torque and passive hip IR ROM. At the moment of landing, the shank-forefoot alignment, abductor isometric torque, and passive hip IR ROM were predictors of high FPKPA. In addition, the classification and regression trees established cutoff points that could be used in clinical practice to identify athletes who are at potential risk for excessive FPKPA. CONCLUSION:The models captured nonlinear interactions between hip abductor isometric torque, passive hip IR ROM, and shank-forefoot alignment.

译文

研究设计:横断面。
目的:探讨运动员额叶膝关节前凸角(FPKPA)增加的预测因素。
背景:导致FPKPA增加的潜在机制可能是多因素的,取决于肌肉骨骼系统如何适应其远端和近端节段之间的可能相互作用。传统上用于分析FPKPA增加的发生的双变量和线性分析不够稳健,无法捕获预测变量之间的复杂关系。对生物力学因素之间的非线性相互作用的研究对于进一步了解下肢节段之间的相互依赖性以及由此产生的动态膝关节对准是必要的。
方法:单腿深蹲时对101名运动员进行了FPKPA评估,跳跃着陆时对72名运动员进行了FPKPA评估。研究的预测指标包括性别,髋关节外展肌等距扭矩,髋关节内部旋转(IR)的被动运动范围(ROM)和小腿前掌对准。使用分类树和回归树来研究预测变量之间的非线性相互作用及其对增加的FPKPA发生的影响。
结果:在单腿下蹲期间,通过髋外展肌等长扭矩与被动髋关节IR ROM的相互作用预测了高FPKPA的发生。在着陆时,小腿前掌对准,外展肌等距扭矩和被动髋关节IR ROM是高FPKPA的预测指标。此外,分类树和回归树确定了临界点,可在临床实践中使用该临界点来识别可能存在过量FPKPA潜在风险的运动员。
结论:该模型捕获了髋关节外展肌等长扭矩,被动髋关节IR ROM和小腿前掌对准之间的非线性相互作用。

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