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Sport-Specific Virtual Reality Tasks Reveal Distinct Patterns of Biomechanical Adaptation Compared With the Drop
Jennifer A Hogg1, Scott Bonnette2, Christopher D Riehm3,4,5
1Department of Health and Human Performance, University of Tennessee Chattanooga, Chattanooga, Tennessee.
Background:
Neuromuscular training (NMT) improves biomechanical risk factors associated with anterior cruciate ligament (ACL) injury yet has failed to abate increasing ACL injury rates at scale. This study assessed sport-specific sensorimotor adaptations resulting from a NMT protocol with additive real-time sensorimotor augmented biofeedback (augmented NMT [aNMT] or sham aNMT) in a standardized drop vertical jump (DVJ) task and in ecologically valid sport-specific tasks performed in a simulated virtual reality (VR) environment.
Hypothesis:
Both training groups will display beneficial biomechanical changes in the standard DVJ, but aNMT will have greater transfer to the VR sport-specific scenario. Biomechanical improvements in DVJ will vary by sport, while improvements in VR sport-specific scenarios will not vary by sport.
Study Design:
Prospective longitudinal randomized placebo-controlled trial.
Level Of Evidence:
Level 1.
Methods:
A total of 271 adolescent female soccer, basketball, and volleyball athletes performed 6 weeks of preseason NMT with additive aNMT or sham aNMT. Three-dimensional biomechanics were assessed at pre-/post-training that included DVJs and sport-specific VR tasks. Pre-/post-training standardized delta scores for both tasks were computed for hip and knee angles and external joint moments. Hierarchical clustering and chi-square analyses (omnibus and within each sport) assessed sport by intervention interactions for biomechanical transfer to both tasks.
Results:
Hierarchical clustering identified 3 DVJ clusters, 2 of which (N = 243) demonstrated beneficial pre-/post-training changes. A small proportion (10%) of athletes classified in a maladaptive cluster that consisted predominantly of aNMT participants, while sham aNMT made up a greater proportion of a beneficial adaptive cluster (χ2 = 6.06; P = 0.05). For the sport-specific VR task, 2 statistical clusters were identified, both characterized primarily by improved hip flexion angles regardless of sport.
Conclusion:
Beneficial effects of aNMT and sham aNMT on the DVJ were observed in most participants, with aNMT accounting for a greater proportion of players exhibiting maladaptive DVJ changes. VR scenarios revealed consistently beneficial changes in landing biomechanics in all participants.
Clinical Relevance:
Sport-specific VR tasks may assess more nuanced levels of movement complexity than traditional laboratory-based tasks and provide a complementary approach to evaluate biomechanical adaptations resulting from NMT.
