Movement and coordination variability following ACL reconstruction: a longitudinal case-study in elite netball
Aims and objectives
The overall aim of this project is to carry out a pilot study on the effects of rehabilitation on movement and coordination characteristics of an elite athlete who has undergone anterior cruciate ligament (ACL) reconstruction surgery. More specifically, the objectives of the research are:
to perform a longitudinal monitoring of running biomechanics and associated coordinative changes throughout the rehabilitative intervention;
to compare movement/coordinative patterns of the injured athlete in comparison with a reference population of healthy individuals;
to compare the outcomes of the biomechanical analysis at each stage of the rehabilitation programme with the clinical/physiotherapy tools that are typically used to evaluate the recovery progression and the return to full function.
ACL injury is a common injury in a multitude of sports, such as netball, where athletes are required to perform high-intensity landing and cutting movements. ACL rupture can be treated either conservatively or through surgical interventions, after which the patient has to undergo a period of physical therapy to regain strength and functionality in the affected limb. Currently, physiotherapists rely on a combination of qualitative assessment and static/dynamic tests to decide on whether the recovering athlete is ready for return to full activity. However evidence from both anecdotal experience and the literature suggests that residual effects on muscle activation, kinematics and kinetics can still be present at the end of the rehabilitation programme. These alterations, together with processes of pain-avoidance and/or fear of recurrent pain, may generate movement adaptation, which in turn may be the cause of recurrent ACL injuries or of the higher rate of osteoarthritis development within 15 years from the operation. It is therefore important to provide quantitative tools that could support the physiotherapist in monitoring the recovery process and in identifying potentially dangerous movement alterations.
Novelty and timeliness
The research is timely because it addresses a common and currently unresolved issue in the
treatment of ACL injuries. Furthermore it introduces two elements of novelty with respect to current
knowledge and published literature:
its prospective design, whereby the athlete’s recovery is observed across its multiple stages
till the return to full activity;
the use of advanced movement and coordination variability measures, which have not been
applied yet in the context of ACL injuries.
Value of the Internship
For the UG student
Holly is a very talented student, who could effectively contribute to the success of this pilot
investigation. She is extremely motivated, technically skilled and a reliable hard worker. She will be
involved in multiple aspects of the research, from data collection (e.g. motion capture) to data
processing (e.g. estimation of kinematic and kinetic parameters, statistical analysis), and she could
eventually take part in the dissemination process (e.g. drafting a conference paper to be submitted for
next annual conference of the International Society of Biomechanics in Sports, ISBS 2015). Holly
wishes to further progress in her studies and pursue a PhD scholarship. This opportunity would be a
fundamental bridge between the completion of her undergraduate degree and the application for PhD
funding. It will expose her to novel research investigations and techniques and it will therefore enrich
her skillset and broaden the range of her work/research experience. It will also allow her to develop
transferrable skills such as interacting with elite athletes and physiotherapist, manage and carry out
experimental sessions and prepare and deliver feedback information to practitioners in the area.
For the applicant(s), the Department for Health and the Faculty of Humanities and Social Sciences
This pilot study is carried out in collaboration with the English Institute of Sports (EIS, reference
person: Mr Chris Mcleod, Lead Strength & Conditioning Coach) and in the short term may lead to a
more systematic partnership between the Department for Health and EIS. EIS has already expressed
lots of interest for this research and has put forward the possibility to fund joint initiatives, starting from
MPhil/PhD scholarships. The results from this study represent a launching platform for the
collaboration and would also give Dr Preatoni and Dr Wilson the opportunity to further develop a
stream of research in their area of expertise, for which at the moment they have no funding available.
These pilot data will offer essential information to support the preparation of future applications
(EPSRC, BBSRC, ARUK) related to understanding how different pathologies and different
rehabilitation interventions could affect movement adaptations and effective recovery in athletes and
other clinical populations such as people affected by osteoarthritis.
The aim of this study and any potential research initiatives that may derive from it are perfectly in line
with the main research themes of the Department and the Faculty. The study is inherently
multidisciplinary (biomechanics, motor control, sport science, physiotherapy, orthopaedics,
psychology), and has many points of contact with other groups within the University (e.g. Centre for
Orthopaedic Biomechanics and the Centre for Pain Research) with whom Dr Preatoni has started
developing collaborative research.
Finally, this research perfectly suits and can further strengthen the emerging link with the Department
of Kinesiology of the University of Massachusetts – Amherst (UMASS), which Dr Preatoni has been
promoting since last Autumn thanks to the Mobility Award he received from the Internationalisation
office, but without having any resources to sustain networking actions with actual research. Prof
Hamill and Prof Van Emmerik from UMASS are outstanding scholars in the area of locomotion and
coordination dynamics and were among the first using the data processing techniques that will be
used in this study. Therefore the availability of a research intern working on pilot data of common
interest between the two groups would be an invaluable support for initiating cooperation and leading
to future common bids.