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

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.

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? 

Nicole Cattano
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