Content uploaded by Casey A. Cottle
Author content
All content in this area was uploaded by Casey A. Cottle on Feb 12, 2015
Content may be subject to copyright.
A COMPARISON OF KNEE MOMENTS DURING A LATERAL CUTTING MANEUVER: SHOD VS.
BAREFOOT
Brianna Bisesti, Casey Cottle, Michael Lawrence, Lara Carlson
University of New England, Biddeford ME
email: bbisesti@une.edu
INTRODUCTION
Noncontact anterior cruciate ligament (ACL)
injuries often occur during cutting and landing
maneuvers [1]. Lateral cutting maneuvers are seen
commonly in most sports, and create the mechanism
of injury for a noncontact ACL injury [1,2,3].
Movements of almost full knee extension, combined
with external or internal tibial rotation [4] occur
during a lateral cutting maneuver that predisposes
an athlete to a potential noncontact ACL injury.
There has been much research on ACL injuries in
the shod population; however, there is no evidence
pertaining to barefoot sports, which are played in
areas around the world, such as Brazil and Africa
[5].
Running barefoot has been the focus of recent
research; however, there has been minimal research
involving other barefoot sports. In barefoot running,
the athlete has more of a forefoot or midfoot strike,
whereas shod runners have a rearfoot strike [6]. By
varying foot strike, changes may transfer up the
kinetic chain to the knees and hips.
Currently there is no research on lateral cutting
maneuvers while barefoot. However lateral cutting
maneuvers have been directly related to causing a
noncontact ACL injury due to the increased
extension, adduction and external rotation knee
movements [7]. The combination of a high
extension, adduction and external rotation knee
moments create the highest load on the ACL, which
can cause a rupture [1,7].
Beiser et al. determined the peak knee moments
during the weight acceptance (WA) phase; (heel
strike to the first trough after the peak vertical
ground reaction force [7]) during lateral cutting. It is
plausible that performing a lateral cutting maneuver
barefoot could alter the kinetics of the lower limb,
which may create a dangerous scenario in an
already precarious maneuver.
Therefore, the purpose of this study was to
determine if knee moments differ between shod
(SD) and barefoot (BF) conditions during lateral
cutting maneuvers. Peak knee extension, adduction,
and external rotation moments during the WA phase
were compared between conditions. We
hypothesized that the BF condition would have a
greater extension, adduction, and external rotation
knee moments than the SD condition.
METHODS
Twelve NCAA Division III athletes (6 males; 6
females) without lower limb pathologies
participated in this study (age, 20.2 + 1.48 yr; mass,
71.17 + 11.3 kg; height, 1.7 + 0.06 m). All subjects
gave their written informed consent to participate in
this study, which was approved by the University’s
Institutional Review Board. The peak extension,
adduction, and external rotation knee moments
during a cutting maneuver were tracked during the
WA phase using a cluster marker set [7].
The motion of each subject was analyzed during 5
trials of 45 degree lateral cutting maneuver for each
limb in both barefoot and shod conditions. Speed
for all trials was set at 4.3 m/s and was controlled
using a Brower laser timing device [2]. Trials were
collected bilaterally; however, for this investigation
only the dominant side was analyzed. Dominance
was determined as the foot used to kick a ball. The
cutting maneuver was performed on an indoor
rubber track (Super X, All Sports Enterprises,
Conshohocken, PA).
Kinematic data were collected with 8 Oqus Series-3
cameras (Qualisys, Gothenburg, Sweden) was set at
240 Hz and kinetic data were collected by an AMTI
BP400600 force plate (AMTI Watertown, MA) set
at 2400Hz. Visual 3D (C-motion, Germantown,
MD) was used to apply a Butterworth filter with a
cutoff of 12 Hz [2] to kinematic data and a filter
with a cutoff of 50Hz to analog data, as determined
by retaining 95% of signal power through a fast
Fourier transformation. Inverse dynamics were used
to calculate internal joint moments at the during the
WA phase. Peak knee extension, adduction, and
external rotation moments in the WA phase were
then found.
Independent t-tests were used to determine whether
the knee moments were greater in the BF or SD
condition for each direction (extension, adduction
and external rotation). Statistical analyses were
performed using SPSS Version 19 (IBM, Chicago,
IL) and statistical significance was accepted at p
<.05.
RESULTS AND DISCUSSION
This is one of the first studies to examine athletic
tasks/maneuvers between BF and SD scenarios.
This study focused on variables that have been
linked to ACL stress. Our hypothesis was not
supported, as no significant differences were found
in the peak extension knee moments between
conditions, and the SD condition produced greater
peak adduction and peak external rotation moments
about the knee (Table 1).
The results of this study suggest that lateral cutting
while BF may place less stress on the ACL than
when SD. Decreased knee moments in the BF
condition may be due to; increased co-contraction
of musculature about the knee [8], altering kinetic
and kinematics diverting greater loads to the ankle
joint, or decreasing ground reaction forces by the
limb in the WA phase.
CONCLUSION
In summary BF lateral cutting provides no more
stress on the ACL than when SD. Therefore, further
investigations should study other phases of stance
such as the peak push off phase and the final push
off phase. In addition, other lower limb joints
should also be considered. A limitation of this study
is that none of the subjects regularly participated in
field sports BF. Nonetheless, our results propose
that BF lateral cutting produces no more risk as
compared to SD in individuals unaccustomed to BF
competition.
REFERENCES
1. O’Connor KM, et al. J Appl Biomech 25(1);
9-21, 2009.
2. Griffin L, et al. J Am Acad Orthop Surg
34(9); 141-50, 2000.
3. Cochrane JL, et al. Med Sci Sports Exerc
42(8); 1535-44, 2010.
4. Bencke J, et al. J Electromyogr Kinesiol
21(2); 371-5, 2011.
5. Boshoff GB. J Sport Manag 11(1); 69-79,
1997.
6. Liberman D, et al. Nature 463(7280); 531-5,
2010.
7. Beiser T, et al. Med Sci Sports Exerc 33(7);
1168-75, 2001.
8. Beiser T, et al. Med Sci Sports Exerc 35(1);
119-27, 2003.
Barefoot = BF; Shod = SD
*denotes difference (p < .05) from SD.
Table 1: Knee Moments (Nm/kg), Mean ± SD
Extension
Adduction
External Rotation
BF
SD
BF
SD
BF
SD
Knee Moment
1.88 ± 0.60
2.17 ± 0.88
0.71 ± 0.33*
1.50 ± 1.04
-0.27 ± 0.19*
-0.42 ± 0.41