Anne Benjaminse

University of Groningen | RUG · Department of Human Movement Sciences

Laboratory studies have limitations in screening for anterior cruciate ligament (ACL) injury risk due to their lack of ecological validity. Machine learning (ML) methods coupled with wearable sensors are state-of-art approaches for joint load estimation outside the laboratory in athletic tasks. The aim of this study was to investigate ML approaches...

Nijmeijer, EM, Kempe, M, Elferink-Gemser, MT, and Benjaminse A. Observe, practice and improve? Enhancing sidestep cutting (SSC) execution in talented female soccer players: A four-week intervention program with video instruction. J Strength Cond Res XX(X): 000–000, 2024—Implicit learning has the potential to improve movement execution and reduce in...

Background Establishing anterior cruciate ligament (ACL) injury risk during cutting movements has traditionally been performed in relatively standardized laboratory environments. This current paradigm inherently assumes that cutting biomechanics is independent of a sport-specific context. However, measuring movement in an ecological valid environme...

Individual performance in team sports is a multifactorial reflection of how well a player can cope and accomplish tasks in varied playing situations. Thus, performance analysis should not only focus on outcomes, but also on underlying mechanisms of those outcomes. We adopted principles of the ecological dynamics approach (EDA) to investigate the ef...

Providing choices, i.e., autonomy, to athletes during practice increases intrinsic motivation and positively influences the motor learning process. The effects of autonomy on the timing of feedback (self-controlled timing of feedback) when optimizing the movement execution of sidestep cutting (SSC), a task that is highly related with ACL injury ris...

Inertial measurement units (IMUs) allow for measurements of kinematic movements outside the laboratory, persevering the athlete-environment relationship. To use IMUs in a sport-specific setting, it is necessary to validate sport-specific movements. The aim of this study was to assess the concurrent validity of the Xsens IMU system by comparing it t...

Athletes who wish to resume high-level activities after an injury to the anterior cruciate ligament (ACL) are often advised to undergo surgical reconstruction. Nevertheless, ACL reconstruction (ACLR) does not equate to normal function of the knee or a reduced risk of subsequent injuries. A rising concern is the high rate of secondary ACL injuries,...

The aim of the present study was to investigate if the presence of anterior cruciate ligament (ACL) injury risk factors depicted in the laboratory would reflect at-risk patterns in football-specific field data. Twenty-four female footballers (14.9 ± 0.9 year) performed unanticipated cutting maneuvers in a laboratory setting and on the football pitc...

Background The outcome after ACL reconstruction (ACLR) is in general disappointing with unacceptable number of athletes that do not return to pre-injury level of sports, high re-injury rates, early development of osteoarthritis and shorter careers. Athletes after ACLR have high expectation to return to sports which is in contrast with the current o...

Background In the European Union, 6.1 million people are being treated in hospital annually for a sports injury. Of this, 31% of these injuries affect young people (15-24 years). Injury incidence, medical and lost productivity costs can be reduced by promoting a healthy and active lifestyle, where attention is paid to primary injury prevention. How...

Observational learning is considered powerful to promote (implicit) motor learning. While it is a common tool in practice , little is known about the effects of video instructions on movement execution. The aim of this study was to investigate the effects of watching biomechanically optimal (OPT) and suboptimal (SUBOPT) sidestep cutting (SSC) video...

Wearable inertial sensors (WIS) facilitate the preservation of the athlete-environment relationship by allowing measurement outside the laboratory. WIS systems should be validated for team sports movements before they are used in sports performance and injury prevention research. The aim of the present study was to investigate the concurrent validi...

Although effort is put forward regarding prevention programs, the rate of ACL injuries in soccer is still high. Autonomy is possibly a key component to improve movement execution and therefore decreasing injury risk. A previous study of our group showed that a self-controlled feedback (SC) group showed better Cutting Movement Assessment scores (CMA...

Background: Limited information is available on the experiences of patients during rehabilitation after anterior cruciate ligament reconstruction (ACLR). Aim: The current study aimed to identify factors that differentiated positive and negative patient experiences during rehabilitation after ACLR. Method and design: A survey-based study with a...

Modifiable (biomechanical and neuromuscular) anterior cruciate ligament (ACL) injury risk factors have been identified in laboratory settings. These risk factors were subsequently used in ACL injury prevention measures. Due to the lack of ecological validity, the use of on-field data in the ACL injury risk screening is increasingly advocated. Thoug...

Although it is advocated that end-users are engaged in developing evidence-based injury prevention training to enhance the implementation, this rarely happens. The ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ uses an ecological participatory design incorporating the perspectives of multipl...

Individuals after anterior cruciate ligament reconstruction (ACLR) have a high rate of reinjury upon return to competitive sports. Deficits in motor control may influence reinjury risk and can be addressed during rehabilitation with motor learning strategies. When instructing patients in performing motor tasks after ACLR, an external focus of atten...

Although the benefits of current anterior cruciate ligament (ACL) injury prevention programmes have been demonstrated in efficacy studies, they, unfortunately, have had limited public health impact to date. For example, the incidence of ACL injuries continues to rise in adolescent athletes. Raising awareness and educating coaches and athletes is no...

Background Despite the importance of sports injury prevention in youth, no broad scale approaches that work in real-life situations with significant positive effects exist. Main reasons for this are poor uptake and maintenance of current sports injury prevention exercises. Objective In order to improve uptake of sports injury prevention routines,...

For lower extremity injury prevention, it is crucial to decrease external loads to the joints in sport-specific situations. The purpose of this study was to examine how landing kinetics and psychological factors (i.e., motivation) change during a four-week laboratory training program. Ten talented soccer girls practiced three sport-specific tasks a...

Research of non-contact anterior cruciate ligament (ACL) inj1ury risk aims to identify modifiable risk factors that are linked to the mechanisms of injury. Information from these studies is then used in the development of injury prevention programmes. However, ACL injury risk research often leans towards methods with three limitations: 1) a poor pr...

Context: Only 55% of the athletes return to competitive sports after an anterior cruciate ligament (ACL) injury. Athletes younger than 25 years who return to sports have a second injury rate of 23%. There may be a mismatch between rehabilitation contents and the demands an athlete faces after returning to sports. Current return-to-sports (RTS) tes...

Background: Differential learning (DL) is a motor learning method characterized by high amounts of variability during practice and is claimed to provide the learner with a higher learning rate than other methods. However, some controversy surrounds DL theory, and to date, no overview exists that compares the effects of DL to other motor learning me...

Athletes in team sports have to quickly visually perceive actions of opponents and teammates while executing their own movements. These continuous actions are performed under time pressure and may contribute to a non-contact ACL injury. However, ACL injury screening and prevention programmes are primarily based on standardised movements in a predic...

Er is geen twijfel over mogelijk dat de motorische vaardigheden van Nederlandse kinderen al decennia lang achteruit gaan. Een peiling van de Inspectie van het Onderwijs 1 concludeert dat de motorische vaardigheid in 2016 weer minder was dan in 2006. Recent gepubliceerd onderzoek 2 laat in deze periode een afname zien in vrijwel alle fitheidsaspecte...

Purpose: It has been reported that there is no correlation between anterior tibia translation (ATT) in passive and dynamic situations. Passive ATT (ATTp) may be different to dynamic ATT (ATTd) due to muscle activation patterns. This study aimed to investigate whether muscle activation during jumping can control ATT in healthy participants. Method...

Introduction Injuries of the anterior cruciate ligament (ACL) commonly occur during complex game situations when the athlete encounters multiple factors such as ball, opponent, field position, and game strategy (Grooms et al., 2018). Many of the current traditional injury screening programs are performed within a predictable, fixed or ‘closed’ envi...

The purpose of this study was to examine the effects of positive and negative instructions on knee joint loading. Eighteen basketball players performed sidestep cut exercises with positive (optimal knee joint loading) and negative (suboptimal knee joint loading) visual instructions given by videos of experts performing side-step cutting. The result...

Currently, screening for ACL injury risk is mostly conducted in a laboratory setting using a drop vertical jump. There remains a lack of knowledge on lower extremity kinematics and injury risk during sport-specific landing movements. Therefore the purpose of this study was to describe the landing kinematics of elite female handball players after a...

Contextual factors influence how the athlete, coach, and clinicians view an injury. The main construct to define a sports injury by athletes is the consequence on sports performance. This in turn may also affect the role and responsibilities each have in the continuum of return to play (RTP). As a coach, it is recommended to have an open communicat...

Background A limited number of patients return to sport (RTS) after an anterior cruciate ligament reconstruction (ACLR) and patients who RTS have a relatively high risk for second ACL injury. The purpose of the current study was to compare the results of a test battery between patients who returned to the pre-injury level of sport (RTS group) and p...

BACKGROUND Despite the importance of sports injury prevention in youth, no broad scale approaches that work in real-life situations with significant positive effects exist. Main reasons for this are poor uptake and maintenance of current sports injury prevention exercises. OBJECTIVE In order to improve uptake of sports injury prevention routines,...

Objectives:The purpose of the current study was to compare the results of a progressive strength training protocol for soccer players after anterior cruciate ligament reconstruction (ACLR) with healthy controls, and to investigate the effects of the strength training protocol on peak quadriceps and hamstring muscle strength.Design:Between subjects...

Athletes who wish to resume high-level activities after an injury to the anterior cruciate ligament (ACL) are often advised to undergo surgical reconstruction. Nevertheless, ACL reconstruction (ACLR) does not equate to normal function of the knee or reduced risk of subsequent injuries. In fact, recent evidence has shown that only around half of pos...

“As ACL injury may alter intracortical facilitation [34] and depressed intracortical inhibition is correlated with decreased quadriceps voluntary activation capability [35], external focus training may provide a means to restore quadriceps muscle activity via increasing intracortical inhibition.

RTS after ACLR

Viele Sportler erleiden Verletzungen des vorderen Kreuzbands – trotz vieler Anstrengungen des Betreuerteams, gefährdete Sportler zu identifizieren und mit entsprechenden Maßnahmen das individuelle Verletzungsrisiko zu senken. Neueste Untersuchungen lenken den Blick auf Kontextfaktoren, die bisher kaum oder nicht in ausreichendem Maß berücksichtigt...

Background Causes of anterior cruciate ligament (ACL) injuries are multifactorial. Anterior cruciate ligament injury prevention should thus be approached from a multifactorial perspective as well. Training to resist fatigue is an underestimated aspect of prevention programs given that the presence of fatigue may play a crucial role in sustaining an...

Background: Implicit (IF) and explicit (EF) feedback are two motor learning strategies demonstrated to alter movement patterns. There is conflicting evidence on which strategy produces better outcomes. The purpose of this study was to examine the effects of reduced IF and EF video feedback on lower extremity landing mechanics. Methods: Thirty pa...

Abstract Purpose The purpose of the current prospective study was to assess the changes over time in patients tested at 6 months and 9 months after anterior cruciate ligament reconstruction (ACLR) with a return to sport (RTS) test battery. It was hypothesized that more patients passed RTS criteria at 9 months compared to 6 months. Methods Sixty-t...

Purpose: The purpose of the current prospective study was to assess the changes over time in patients tested at 6 months and 9 months after anterior cruciate ligament reconstruction (ACLR) with a return to sport (RTS) test battery. It was hypothesized that more patients passed RTS criteria at 9 months compared to 6 months. Methods: Sixty-two ACL...

The authors present their thoughts on the focus on targeting asymmetry in rehabilitation after ACL reconstruction, which they think may not be rich enough to identify deficits.

PurposeThere is a lack of objective factors which can be used in guiding the return to sport (RTS) decision after an anterior cruciate ligament reconstruction (ACLR). The purpose of the current study was to conduct qualitative analysis of the single leg hop (SLH) in patients after ACLR with a simple and clinical friendly method and to compare the p...

Findings from efficacy studies have shown decreased in ACL injury rates in (predominantly female) athletes participating in prevention programs. Given the inherent higher ACL injury risk for females, the majority of intervention studies, have focused on female athletes. Subsequently, the content of exercises in ACL prevention programs is directed t...

ABSTRACT Background: Retention of movement technique is crucial in anterior cruciate ligament (ACL) injury prevention programs. It is unknown if specific instructions or video instructions result in changes in kinematic and kinetic measures during a relatively short training session, and in a retention test one week later. Hypothesis/Purpose: The p...

Context: In team handball, an anterior cruciate ligament injury often occurs during landing after a jump shot. Many intervention programs try to reduce the injury rate by instructing athletes to land more safely. Video is an effective way to provide feedback, but little is known about its influence on landing technique in sport-specific situations...

PurposeIt is unknown how movement patterns that are learned carry over to the field. The objective was to determine whether training during a jump-landing task would transfer to lower extremity kinematics and kinetics during sidestep cutting. Methods Forty healthy athletes were assigned to the verbal internal focus (IF, n = 10), verbal external foc...

Introduction: Cutting is an important skill in team-sports, but unfortunately is also related to non-contact ACL injuries. The purpose was to examine knee kinetics and kinematics at different cutting angles. Material and methods: 13 males and 16 females performed cuts at different angles (45°, 90°, 135° and 180°) at maximum speed. 3D kinematics...

Background: Hop tests are frequently used to determine return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). Given that bilateral deficits are present after ACLR, this may result in a falsely high limb symmetry index (LSI), since LSI is calculated as a ratio between the values of the limbs. Hypothesis: Athletes after ACL...

Background Lower extremity(LE) patterns have been altered using implicit(IF) and explicit(EF) feedback motor learning strategies, however, it remains unclear which strategy may be more effective for injury prevention. Objective To examine the effects of reduced relative IF and EF video-feedback on LE biomechanics. Design Randomized Controlled Tri...

Background It is unknown if learned motor skills as practiced in ACL injury prevention training carry over to other tasks. Objective Determine if training of a jump-landing task results in transfer of improvement in lower extremity biomechanics during sidestep cutting. Design Randomized controlled trial. Setting Controlled laboratory setting, re...

Background In handball an anterior cruciate ligament injury often occurs during a jump shot landing. Video feedback is effective to improve landing although little is known about its influence in sport-specific movements. Objective Test effectiveness of video overlay feedback on landing technique. Design Randomized controlled trial. Setting Cont...

Video feedback may be a powerful tool to change biomechanical landing patterns associated with anterior cruciate ligament (ACL) injury risk. This study investigated the effect of video feedback on drop vertical jump (DVJ) landing strategies in team sport athletes. 59 athletes were assigned to a video feedback (VI) or control (CTRL) group. A pretest...

The aim of this study is to investigate the predictive value of landing stability and technique to gain insight into risk factors for ankle and knee injuries in indoor team sport players. Seventy-five male and female basketball, volleyball or korfball players were screened by measuring landing stability after a single-leg jump landing and landing t...

The seventh ACL Research Retreat was held March 19–21, 2015, in Greensboro, North Carolina. The retreat brought together clinicians and researchers to present and discuss the most recent advances in anterior cruciate ligament (ACL) injury epidemiology, risk factor identification, and injury risk screening and prevention strategies. Subsequently, ou...

Context: Knee injuries commonly occur in later stages of competition indicating that fatigue may influence dynamic knee stability. Force sense (FS) is a submodality of proprioception influenced by muscle mechanoreceptors, and, if negatively affected by fatigue, may results in less effective neuromuscular control. Objectives: To determine the eff...

Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruciate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulus during unexpected sidestep cutting in female and male ath...

Objectives: To evaluate dynamic stability index (DSI) differences between males and females for different jump directions. To examine both preseason DSI differences between players with and without a history of ankle sprain, and between players with and without an ankle sprain during the subsequent season. Design: Prospective cohort design. Set...

Synopsis: Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence is still high, making it imperative to continue to improve current prevention strategies. A potential limitation of current ACL injury prevention training may be a deficit...

Purpose The purpose of this study was to evaluate the influence of immersion in a virtual reality environment on knee biomechanics in patients after ACL reconstruction (ACLR). It was hypothesized that virtual reality techniques aimed to change attentional focus would influence altered knee flexion angle, knee extension moment and peak vertical grou...

Background Knee injuries are one of the most common types of injuries in team ball sports, and prevention is crucial because of health and economic implications. To set up effective prevention programs, these programs must be designed to target potential, modifiable risk factors. In addition, it is essential to evaluate the effects of these preven...

Objectives The purpose of this study was to determine the effect of an internal and external attentional focus on single leg hop jump distance and knee kinematics in patients after ACL reconstruction (ACLR). Design Experimental. Setting Outpatient physical therapy facility. Participants Sixteen patients after ACLR. Main Outcome Measures Patient...

Background Anterior cruciate ligament (ACL) injury prevention programs have been successful in the short term. Motor learning strategies with an internal focus (IF) to body movements have traditionally been utilized, but may be less suitable than an external focus (EF) for the acquisition and control of complex motor skills required for sport. Obj...

Background: Fatigue has been shown to affect performance of hop tests in patients after anterior cruciate ligament reconstruction (ACLR) compared to uninjured controls (CTRL). This may render the hop test less sensitive in detecting landing errors. The primary purpose of this study was to investigate the effect of lower extremity fatigue on landin...

Neuropsychological capabilities in athletes may be associated with a predisposition to anterior cruciate ligament (ACL) injuries. Assess differences between male and female athletes in jump-landing technique in relation to their neuropsychological capabilities. Experimental. Laboratory. 31 recreational athletes, free from lower extremity injuries,...

Anterior cruciate ligament (ACL) injury prevention programs have shown mixed results, which may be in part due to suboptimal training components. Determine effects of a prevention program with external and internal focus of attention on (potential) biomechanical risk factors for ACL injury. Pretest-posttest control group. Laboratory and field. 31 e...

Primary anterior cruciate ligament (ACL) injury prevention training has been shown to reduce the risk of injury. Less is known about the effect of prevention on second injury after ACL reconstruction (ACLR). Given recent findings that second injury rates exceed 20 % in only the first year following the return to sport, it is imperative that rehabil...

Background: Current clinical outcome measurements may overestimate the long term success of anterior cruciate ligament reconstruction (ACLR). There is a need to understand biomechanics of the knee joint during daily activities. This systematic review provides a comprehensive overview of the literature related to gait in patients following ACLR. The...

Current clinical outcome measurements may overestimate the long term success of anterior cruciate ligament reconstruction (ACLR). There is a need to understand biomechanics of the knee joint during daily activities. This systematic review provides a comprehensive overview of the literature related to gait in patients following ACLR. The purpose of...

To determine the most effective practices for quadriceps strengthening after ACL reconstruction. An electronic search has been performed for the literature appearing from January 1990 to January 2012. Inclusion criteria were articles written in English, German or Dutch with unilateral ACL-reconstructed patients older than 13 years, RCT rehabilitati...

Background: Injuries to lower extremities are common in team sports such as soccer, basketball, volleyball, football and field hockey. Considering personal grief, disabling consequences and high costs caused by injuries to lower extremities, the importance for the prevention of these injuries is evident. From this point of view it is important to...

Background: Injuries to lower extremities are common in team sports such as soccer, basketball, volleyball, football and field hockey. Considering personal grief, disabling consequences and high costs caused by injuries to lower extremities, the importance for the prevention of these injuries is evident. From this point of view it is important to k...

To establish the clinical relevance of proprioceptive deficits reported after anterior cruciate ligament (ACL) injury. A literature search was done in electronic databases from January 1990 to June 2009. Inclusion criteria for studies were ACL deficient (ACL-D) and ACL reconstruction (ACL-R) articles written in English, Dutch or German and calculat...

Background Despite reported early successes, anterior cruciate ligament (ACL) injury rates have not diminished. Currently explicit learning strategies are mainly used for prevention. However, this may be unsuitable for the control of complex motor skills. Objective The purpose was to investigate explicit and implicit learning while keeping balance...

Female athletes have a significantly higher risk of sustaining an anterior cruciate ligament (ACL) injury than male athletes. Biomechanical and neuromuscular factors have been reported as the main cause. The purpose of this review was to critically review results of the published literature on gender differences regarding biomechanical and neuromus...

Purpose What happens to the transference of learning proper jump-landing technique in isolation when an individual is expected to perform at a competitive level yet tries to maintain proper jump-landing technique? This is the key question for researchers, physical therapists, athletic trainers and coaches involved in ACL injury prevention in athlet...

Of all athletic knee injuries an anterior cruciate ligament (ACL) rupture results in the longest time loss from sport. Regardless of the therapy chosen, conservative or reconstructive, athletes are often forced to reduce their level of physical activity and their involvement in sport. Moreover, a recent review reported prevalences of osteoarthritis...

What happens to the transference of learning proper jump-landing technique in isolation when an individual is expected to perform at a competitive level yet tries to maintain proper jump-landing technique? This is the key question for researchers, physical therapists, athletic trainers and coaches involved in ACL injury prevention in athletes. The...