A comparison of hamstring muscle activity during different screening tests for non-contact ACL injury.

BACKGROUND: Reduced ability to activate the medial hamstring muscles during a sports-specific sidecutting movement has been found to be a potential risk factor for non-contact ACL injury. However, whether a reduced ability to activate the medial hamstring muscle is a general neuromuscular phenomenon and thereby observable independently of the type of clinical screening tests used is not known. This cross sectional study investigated the rank correlation of knee joint neuromuscular activity between three different ACL injury risk screening tests.

METHODS: Sixty-two adolescent female elite football and handball players (16.7±1.3years) participated in the study. Using surface electromyography (EMG) assessment, the neuromuscular activity of medial hamstring muscle (semitendinosus, ST), lateral hamstring muscle (biceps femoris, BF) and quadriceps muscle (vastus lateralis, VL) were monitored during three standardized screening tests - i.e. one-legged horizontal hop (OLH), drop vertical jump (DJ) and sidecutting (SC). Neuromuscular pre-activity was measured in the time interval 10ms prior to initial contact on a force plate.

RESULTS: For neuromuscular hamstring muscle pre-activity, correlation analysis (Spearman correlation coefficient) showed low-to-moderate correlations between SC and 1) DJ (rs=0.34-0.36, P<0.05) and 2) OLH (rs=0.40-0.41, P<0.05), respectively.

CONCLUSIONS: In conclusion, the present data suggest that hamstring pre-activity share some common variance during the examined tests. However, a lack of strong correlation suggests that we cannot generalize one risk factor during one test to another test.

CLINICAL RELEVANCE: The present data demonstrate that one-legged horizontal hop and drop vertical jump testing that are commonly used in the clinical setting does not resemble the specific neuromuscular activity patterns known to exist during sidecutting, a well known high risk movement for non-contact ACL injury.