Inertial Sensor-Based Feedback Can Reduce Key Risk Metrics for Anterior Cruciate Ligament Injury During Jump Landings

Abstract

Background: The incidence of anterior cruciate ligament (ACL) injury can be decreased through the use of intervention programs. However, the success of these programs is dependent on access to a skilled trainer who provides feedback; as such, these programs would benefit from a simple device with the capacity to provide high-quality feedback. Hypothesis: Feedback based on kinematic measurements from a simple inertial sensor-based system can be used to modify key ACL injury risk metrics (knee flexion angle, trunk lean, knee abduction moment) during jump landing. Study Design: Controlled laboratory study. Methods: Seventeen subjects (7 male) were tested during drop jump tasks. Their movements were measured simultaneously with inertial, optoelectronic, and force platform systems. Feedback provided to the subjects was based only on measurements from the inertial sensor-based system (knee flexion angle, trunk lean, and thigh coronal velocity). The subjects conducted a baseline session (without landing instructions), then a training session (with immediate feedback), and finally an evaluation session (without feedback). The baseline and evaluation sessions were then tested for changes in the key risk metrics. Results: The subjects increased their knee flexion angle (16.2°) and trunk lean (17.4°) after the training. They also altered their thigh coronal angular velocity by 29.4 deg/s and reduced their knee abduction moment by 0.5 %BW·Ht. There was a significant correlation ( R² = 0.55) between the change in thigh coronal angular velocity and the change in knee abduction moment. Conclusion: Subjects reduced key risk metrics for ACL injury after training with the system, suggesting the potential benefit of instrumented feedback for interventional training. Clinical Relevance: Interventional training for reducing the risk of ACL injury could be improved with a simple device that provides immediate feedback.