Sports Medicine Research: In the Lab & In the Field: Real-Time Feedback Helps Improve Landing Techniques in Gymnasts (Sports Med Res)


Wednesday, August 5, 2015

Real-Time Feedback Helps Improve Landing Techniques in Gymnasts

Real-time feedback during drop landing training improves subsequent frontal and sagittal plane knee kinematics

Nyman E, & Armstrong CW. Clinical Biomechanics. 2015; E pub ahead of print.

Take Home Message: Real-time feedback with Microsoft Kinect-based software helps to improve landing techniques in a female gymnastics.

Poor landing mechanics may predispose individuals to non-contact anterior cruciate ligament (ACL) injuries. Real-time feedback during activities can help to improve neuromuscular control; however, real-time feedback training has not been widely implemented in a clinical setting.  New advancements in video games systems (e.g., Microsoft Kinect) may enable clinicians to implement real-time feedback training with minimal expense, time and space.  The authors of this randomized trial investigated whether 4 weeks of real-time feedback from software using a Microsoft Kinect would help female gymnasts improve neuromuscular control and landing techniques.  Gymnasts (~15 years old) that had no history of surgery nor a recent lower extremity, spine, or concussion injury were randomly assigned to either the Kinect-based feedback group or the control group, resulting in 12 gymnasts per group.  Prior to the interventions, all participants performed a drop landing-to-jump task so the authors could assess peak knee flexion angle and minimum knee separation distance.  All participants completed the intervention training with 20 drop landings 3 days per week for 4 weeks; however, the Kinect-based feedback group completed this task while watching themselves in real-time on a monitor that used software that gave auditory and colored cues for correct and/or abnormal movement patterns.  After 4 weeks the authors re-evaluated the participants’ peak knee flexion angle and minimum knee separation distance during a drop landing-to-jump tasks. The Kinect-based feedback group had a 46% improvement in peak knee flexion angle, which was a greater change than the control group that had very little change in peak knee flexion angle. The Kinect-based feedback group also had a 21% increase in the minimum knee separation distance, which was a greater change than the 8% change by the control group.    

The authors of this study found that real-time feedback training using software is effective at altering landing mechanics that are often associated with ACL tears.  The Kinect-based software feedback provides objective and tangible goals for athletes to strive for during an intervention program.  It would be interesting to see a comparison of real-time training using the Kinect software system compared with real-time feedback by a clinician or coach.  This research shows positive outcomes after an intervention program, but it remains unknown as to how long these changes may last after cessation of the intervention program or what the external generalizability of these findings may be to other athletic or physically active populations.  Female gymnasts are an especially unique population because they are susceptible to ACL injuries, just like other athletic and physically active females; however, they have a tendency to land more stiff than other female athletes as a result of their sport.  It would be interesting to see the findings of these results in other ACL susceptible populations such as female soccer or basketball athletes.  While a Kinect-based feedback program may not be realistically feasible for team interventions, it could be a valuable tool to be used within the knee-injury rehabilitation setting or for an athlete identified as high-risk. 

Questions for Discussion:  Are there any intervention or training programs that you clinically use to improve landing techniques? 

Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

Related Posts:

Nyman, E., & Armstrong, C. (2015). Real-time feedback during drop landing training improves subsequent frontal and sagittal plane knee kinematics Clinical Biomechanics DOI: 10.1016/j.clinbiomech.2015.06.018


Jennifer Cornelius said...

This article is very intriguing in regards to the incorporation of real time feedback during landing. Using this technique not only allows for the researchers to know specifically what to focus on in their drop landing, but also presents them with a technique that may help prevent non-contact ACL tears in the future. Techniques I have used include, but are not limited to, basic plyometrics such as box jumps, depth jumps, squat jumps, and lateral jumps. Although those are methods that are well known and beneficial, not every athlete is able to perform these techniques properly or even at all. Being able to witness landing techniques as they occur would eliminate the redundancy of predisposing behaviors. Too often we allow for athletes to perform the way they are most familiar with because we underestimate the long term effects of poor biomechanics or due to time restraints when in reality, it is the leading factor in most injury occurrences. I would be interested to see the usage of real time incorporated in agility drills or even in a live practice setting. This would allow for researchers to witness an athletes natural performance behavior.

Brooke Daniell said...

The use of real-time feedback has quickly become a topic of interest in sports medicine. This was a great study overall, and I think that the use of real-time feedback via enhanced technology truly is one of the best ways to fine-tune and re-educate the muscles of our patients and prevent injury. It would be interesting to follow a group of athletes using this protocol a few times per week during pre-season and regular season, and look at their injuries (specifically ACL) compared to previous years, as well as other teams not using this same technology.

Alexandra DeJong said...

I think this article presented very important data regarding visual and verbal feedback during a dynamic task, specifically for a younger athletic population. Much of the intervention programs using visual feedback target older, pathological populations. This study demonstrates that feedback can be utilized to improve mechanics in younger, active populations as well. I also think that this drop landing task was particularly important to perform for gymnasts as this is a large demand for sport, but as Jennifer commented, it would be interesting to see how the feedback would carry over to other tasks and other sports. Additionally, individuals with previous ACL injury are predisposed to future injury, so it would be important to see if this training would carry over to ACLR patients.

Nicole Cattano said...

Jennifer, Brooke, and Alexandra all bring up really great points. While you can "tell" someone what they are supposed to do - it is never as good as realtime feedback and making adjustments that the athletes can neuromuscularly make adjustments and recall how it "feels". These techniques also help to ensure compliance and accuracy by taking out human error.

I agree - this would be very interesting to see in an ACLR group.

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