Neuromuscular Function and Performance in Alpine Ski Racers with Anterior Cruciate Ligament Reconstruction: A Return to Sport Framework

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atmire.migration.oldid5424
dc.contributor.advisorHerzog, Walter
dc.contributor.advisorAagaard, Per
dc.contributor.authorJordan, Matthew J
dc.contributor.committeememberHeard, Mark
dc.contributor.committeememberDoyle-Baker, Patricia
dc.contributor.committeememberKolb, Jon
dc.contributor.committeememberHolmberg, Hans-Christer
dc.contributor.committeememberEdwards, Brent
dc.date.accessioned2017-04-13T20:07:05Z
dc.date.available2017-04-13T20:07:05Z
dc.date.issued2017
dc.date.submitted2017en
dc.description.abstractThe primary aim of this study was to evaluate the effects of ACL injury on neuromuscular function in elite alpine ski racers, and to monitor skiers throughout the return to sport transition. In Chapter 2 a narrative review of the literature was performed on ACL injury, ACL re-injury, and return to sport after ACL injury in ski racing. In Chapter 3, a new test of inter-limb functional asymmetry was used to evaluate alpine ski racers with/without ACL reconstruction (ACLR). Despite a full return to competition, ACLR ski racers demonstrated elevated inter-limb functional asymmetries that were correlated with lower limb muscle mass asymmetry. In Chapter 4, hamstring/quadriceps strength ratios were measured in ski racers with/without ACLR. ACLR ski racers displayed significant hamstring/quadriceps strength deficits in the ACLR limb compared to the contralateral limb and the limb average of non-injured skiers. In Chapter 5, the functional lower-limb asymmetry test introduced in Chapter 3 was used to evaluate the acute effects of a fatiguing jump protocol on asymmetry and hamstring/quadriceps muscle activity in ski racers with/without ACLR. The ACLR skiers displayed systematic inter-limb functional asymmetries. ACLR skiers displayed reduced quadriceps muscle activity at takeoff in the surgical limb. Both the ACLR group and non-injured controls became quadriceps dominant with fatigue. Quadriceps muscle activity increased while hamstring muscle activity decreased. Notably, this was found in the pre-landing phase. In Chapter 6, primary ACLR operative reports from 28 skiers were analyzed to evaluate the associated pathology including multi-ligament injury, meniscal tears and chondral lesions. Operative reports from future surgeries were analyzed to evaluate the injury progression. At the time of primary ACLR, there was a higher proportion of chondral lesions in the lateral compartment compared to the medial compartment, and complex meniscal tears compared to one-dimensional tears. At the time point of future surgery, a significant proportion of skiers showed a worsening of chondral lesions, including half of the skiers presenting with Grade 3 or Grade 4 lesions. Functional asymmetry was also evaluated at various time points following primary ACLR. Nearly two years were required for functional asymmetry indices to reach values comparable to those of non-injured ski racers.en_US
dc.identifier.citationJordan, M. J. (2017). Neuromuscular Function and Performance in Alpine Ski Racers with Anterior Cruciate Ligament Reconstruction: A Return to Sport Framework (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/27086en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/27086
dc.identifier.urihttp://hdl.handle.net/11023/3696
dc.language.isoeng
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectMedicine and Surgery
dc.subjectRehabilitation and Therapy
dc.subject.otherKnee injury
dc.subject.otheralpine skiing
dc.subject.otherinjury prevention
dc.subject.otherknee ligaments
dc.subject.otherreturn to sport
dc.subject.otherreturn to play
dc.subject.otherre-injury
dc.subject.otherBiomechanics
dc.subject.otherneuromuscular
dc.titleNeuromuscular Function and Performance in Alpine Ski Racers with Anterior Cruciate Ligament Reconstruction: A Return to Sport Framework
dc.typedoctoral thesis
thesis.degree.disciplineMedical Science
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameDoctor of Philosophy (PhD)
ucalgary.item.requestcopytrue
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