Volume 7, Issue 1 (6-2021)                   J Sport Biomech 2021, 7(1): 56-67 | Back to browse issues page


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Golmoradi Marani M, Letafatkar A, Shojaedin S S. Comparison of Motion Control Screening Test Scores in Active Women With a History of Knee and Ankle Injuries. J Sport Biomech. 2021; 7 (1) :56-67
URL: http://biomechanics.iauh.ac.ir/article-1-247-en.html
1- Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran.
2- Department of Health and Sports Medicine, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran.
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1. Introduction
Although the benefits of exercise have always been important in maintaining the health of society, at the same time, sports activities are a risk factor for causing traumatic injuries among athletes [1]. Today, with the increasing tendency of young people to play sports, the rate of sports injuries is also increasing [2]. According to the National Collegiate Athletic Association, about 182,000 sports injuries occurred between 1988 and 2004, with knee and ankle injuries being the most common [3]. Research has also revealed that women are more likely than men to be injured during exercise [4-6].
In order to prevent sports injuries, having basic knowledge of biomechanics, anatomy, physiology and kinesiology is essential [7]. By recognizing the causes of injury, we can invest in areas that prevent injury and avoid further occurrence or progression of injury [8]. One of the most important causes of injury is motion control disorders, the identification and correction of which is recognized as an important part of injury assessment and rehabilitation [9]. Neuromuscular control, central instability, and muscle imbalance have also been identified as contributing factors to injury [10-12].
Due to the increasing incidence of sports injuries, pre-season screening of athletes is common nowadays [7]. These screenings as part of injury risk management strategies can be useful in predicting re-injury [13, 14]. Therefore, with the increasing need to identify the probability of injury with high accuracy, a new method of screening has been developed. These tools are a set of motion control tests that can be used as a measurement tool to identify movement disorders using a set of polyarticular functional tests [14].
Pre-season screening of athletes can be very important and reduce injury time, improve motor function, and prevent injury before it occurs [7]. Therefore, the aim of this study was to investigate the relationship between the scores of motion control screening tests in active women with a history of injury, and to determine the predictive score for injury.

2. Methods
The statistical population of this study included all active women aged 18-25 years in Kharazmi University. Based on the inclusion criteria, 57 of them were selected as available samples. Thirty-five subjects had a history of lower limb injuries (19 with a history of ankle injuries and 16 with a history of knee injuries), of which 25 had non-impact injuries and 10 had impact injuries.
In the test session, the examiner orally explained each of the tests to the participants. Then the test process started and after warming up for five minutes, the test was performed. During the tests, the participants’ performance was videotaped from four different angles by four digital cameras and then used for scoring (required sequences were extracted by Corel protractor software). These tests lasted 25-30 minutes and included 9 tests: Double Knee Swing, Single leg ¼ squat+hip turn, Bridge+straight leg lift & lower, Controlled shoulder internal rotation, 4 point-arm reach forward and back, Plank+lateral twist, One arm wall push, Split squat+fast feet, Lateral stair hop+rotational landing control [9, 13]. Each of these tests presents several criteria in the form of questions that require observational judgments about a person’s ability to control movement with standard criteria (40 criteria in total), each of which was answered in the affirmative or negative. For statistical analysis, Kolmogorov-Smirnov test was used to check the normality of the data, Levene’s test was used for data homogeneity, one-way ANOVA and Scheffe post hoc tests were used to examine the intergroup differences. Finally, the data were analyzed by SPSS software v. 22 (Table 1).



3. Results
In order to perform the one-way ANOVA statistical test, the assumption of normality of data and variance homogeneity in the variables under study was investigated. The results indicated that the assumption of homogeneity of variance and normality of data (P>0.05) was established in all research variables.
According to the results of ANOVA test, there was a significant difference in the scores of motion control test between the groups with a history of “ankle injury”, “knee injury”, and “no injury”. Therefore, Scheffe post hoc test was used to investigate the differences between the means of all three experimental groups. The results of Scheffe test revealed that there was a significant difference in the scores of motion control tests between the “ankle injury” and “no injury” groups and also between the “knee injury” and “no injury” groups (P=0.001). The results revealed that the scores of these tests are lower for the “no injury” group than the “ankle injury” group, and relatively lower for the “ankle injury” group than the “knee injury” group, respectively. Therefore, the “no injury” group had the least motion control disorder and the “knee injury” group had the most.
Also, according to the results of the ANOVA and Scheffe statistical tests, there was a significant difference in the scores of motion control test between the “impact injury”, “non-Impact injury” and “no injury” groups. The “impact injury” group had higher scores than the “non-impact injury” group, which indicates more motion control disorder.
Results of Scheffe test between the “impact injury”, “non-Impact injury”, “ankle injury”, “knee injury” and “no injury” groups in motion control test scores. Drawing and analysis of the ROC curve revealed that the cut-off obtained for this test is 15.5.


4. Discussion and Conclusion
The aim of this study was to investigate the relationship between the motion control test scores in active women with a history of injury and determine the predictive score to identify people prone to injury. The results indicated that the scores of motion control tests of the women with a history of ankle and knee injuries were significantly different from the scores obtained by women without lower limb injury (P=0.001). Although the score of these tests was lower for the “ankle injury” group than the “knee injury” group, no significant difference was observed between the two groups. The results also revealed that there was a significant difference between the motion control scores of the “non-impact injury” and “impact injury” groups with the “no injury” group. While there was no significant difference between the “impact injury” group and the “non-impact injury” group.
Many studies have examined the relationship between screening tests and the occurrence of injuries, and present screening test scores as a predictor of injury. In this study, a score of 15.5 was determined as the cut-off score (predictor) and ,in general, the participants who scored lower in the screening tests were less prone to injury. Therefore, in order to use these tests in diagnostic assessments and prevention of lower limb injuries, the probability of injury should be estimated in proportion to the individual’s score.
 This study was one of the first researches about the evaluation of lower limb motion control based on field tests. Sports coaches and sports injury prevention officials are advised to use the results of this study and other research related to sports injury prevention. In addition to performing medical tests, they can also use motion control screening tests as a valid tool, and thus by measuring the level of performance of athletes they can identify people at risk before the start of the competition season and can improve the athletes’ abilities.

Ethical Considerations
Compliance with ethical guidelines

All ethical principles are considered in this article. The participants were informed about the purpose of the research and its implementation stages. They were also assured about the confidentiality of their information and were free to leave the study whenever they wished, and if desired, the research results would be available to them.

Funding
The study was extracted from MA. thesis of first author the Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran. 

Authors' contributions
All authors equally contributed to preparing this article.

Conflicts of interest
The authors declared no conflict of interest.

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Type of Study: Applicable | Subject: Special
Received: 2021/02/6 | Accepted: 2021/04/26 | Published: 2021/06/21

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