{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:31Z","timestamp":1787028691716,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,4,7]],"date-time":"2024-04-07T00:00:00Z","timestamp":1712448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>The purpose of this study was to determine if women footballers have an increased lack of neuromuscular control of the knee joint after a concussion compared to a healthy cohort tested with tensiomyography (TMG). Forty-one female collegiate footballers were enrolled in this study from which there were 20 with a history of sports-related concussions (SRCs) and 21 control subjects. Results from the SRC group had significantly higher Tc (ms) (z = \u22125.478, p = 0.000) and significantly lower Dm (mm) (z = \u22123.835, p = 0.000) than the control group in the case of the rectus femoris muscle. The SRC group had significantly higher Tc (ms) (z = \u22122.348, p = 0.016) and significantly lower Dm (mm) (z = \u22124.776, p = 0.000) than the control group in the case of the vastus medialis muscle. The SRC group had significantly higher Tc (ms) (z = \u22125.400, p = 0.000) and significantly lower Dm (mm) (z = \u22124.971, p = 0.000) than the control group in the case of the vastus lateralis muscle. The SRC group had significantly higher Tc (ms) (z = \u22125.349, p = 0.000) than the control group in the case of the biceps femoris muscle response, whereas no significant difference was found in Dm (mm) (z = \u22120.198, p = 0.853) between the groups. The results of the current study may have implications for current practice standards regarding the evaluation and management of concussions and can add valuable information for knee prevention programs as well.<\/jats:p>","DOI":"10.3390\/jfmk9020065","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T12:01:22Z","timestamp":1712577682000},"page":"65","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Mechanical and Contractile Properties of Knee Joint Muscles after Sports-Related Concussions in Women Footballers"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9138-6994","authenticated-orcid":false,"given":"Georgios","family":"Kakavas","sequence":"first","affiliation":[{"name":"Fysiotek Spine and Sports Lab, 11635 Athens, Greece"},{"name":"ErgoMechLab, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Tsiokanos","sequence":"additional","affiliation":[{"name":"ErgoMechLab, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Potoupnis","sequence":"additional","affiliation":[{"name":"Medical School, 3rd Academic Orthopedic Clinic, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6626-5795","authenticated-orcid":false,"given":"Panagiotis V.","family":"Tsaklis","sequence":"additional","affiliation":[{"name":"ErgoMechLab, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"},{"name":"Department of Molecular Medicine and Surgery, Growth and Metabolism, Karolinska Institute, 17164 Solna, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1080\/02699050902788485","article-title":"Alterations to locomotor navigation in a complex environment at 7 and 30 days following a concussion in an elite athlete","volume":"23","author":"Fait","year":"2009","journal-title":"Brain Inj."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/HTR.0b013e3182407ace","article-title":"Altered integrated locomotor and cognitive function in elite athletes 30 days postconcussion: A preliminary study","volume":"28","author":"Fait","year":"2013","journal-title":"J. Head Trauma Rehabil."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2451","DOI":"10.1016\/j.jbiomech.2004.10.020","article-title":"Spatial fiber type distribution in normal human muscle: Histochemical and tensiomyographical evaluation","volume":"38","author":"Dahmane","year":"2005","journal-title":"J. Biomech."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1080\/02640414.2010.548822","article-title":"Assessment of muscle fatigue after an ultra-endurance triathlon using tensiomyography (TMG)","volume":"29","author":"Sarmiento","year":"2011","journal-title":"J. Sports Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/1743-0003-6-25","article-title":"Different gait tasks distinguish immediate vs. long-term effects of concussion on balance control","volume":"6","author":"Catena","year":"2009","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.apmr.2010.11.029","article-title":"The Chronic Effects of Concussion on Gait","volume":"92","author":"Martini","year":"2011","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1177\/0363546504269591","article-title":"Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: A prospective study","volume":"33","author":"Hewett","year":"2005","journal-title":"Am. J. Sports Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1177\/0363546507301585","article-title":"Deficits in neuromuscular control of the trunk predict knee injury risk: A prospective biomechanical-epidemiologic study","volume":"35","author":"Zazulak","year":"2007","journal-title":"Am. J. Sports Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1136\/bjsports-2013-093406","article-title":"Sports-related concussion increases the risk of subsequent injury by about 50% in elite male football players","volume":"48","author":"Nordstrom","year":"2014","journal-title":"Br. J. Sports Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1136\/bjsports-2015-094982","article-title":"Professional Rugby Union players have a 60% greater risk of time loss injury after concussion: A 2-season prospective study of clinical outcomes","volume":"50","author":"Cross","year":"2015","journal-title":"Br. J. Sports Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"329","DOI":"10.4085\/1062-6050-51.5.02","article-title":"\u201cPlaying Through It\u201d: Delayed Reporting and Removal From Athletic Activity After Concussion Predicts Prolonged Recovery","volume":"51","author":"Asken","year":"2016","journal-title":"J. Athl. Train."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.3109\/02699052.2015.1035324","article-title":"Effect of soccer heading ball speed on S100B, sideline concussion assessments and head impact kinematics","volume":"29","author":"Dorminy","year":"2015","journal-title":"Brain Inj."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/02701367.2008.10599486","article-title":"Examining the relationship between purposeful heading in soccer and computerised neuropsychological test performance","volume":"79","author":"Kaminski","year":"2008","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1177\/0009922815606417","article-title":"Gender Differences in Recovery From Sports-Related Concussion in Adolescents","volume":"55","author":"Baker","year":"2016","journal-title":"Clin. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1080\/15438627.2016.1234472","article-title":"Validation and calibration of HeadCount, a self-report measure for quantifying heading exposure in soccer players","volume":"24","author":"Catenaccio","year":"2016","journal-title":"Res. Sports Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/00042752-200004000-00004","article-title":"The acute neuropsychological effects of heading in soccer: A pilot study","volume":"10","author":"Putukian","year":"2000","journal-title":"Clin. J. Sport Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e550","DOI":"10.1542\/peds.2009-3101","article-title":"Emergency Department Visits for Concussion in Young Child Athletes","volume":"126","author":"Bakhos","year":"2010","journal-title":"Pediatrics"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1080\/092970490959629","article-title":"Neuropsychological impairment as a consequence of football (soccer) play and football heading: A preliminary analysis and report on school students (13\u201316 years)","volume":"11","author":"Stephens","year":"2005","journal-title":"Child Neuropsychol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"271","DOI":"10.3109\/02699052.2013.865269","article-title":"Concussions and heading in soccer: A review of the evidence of incidence, mechanisms, biomarkers and neurocognitive outcomes","volume":"28","author":"Maher","year":"2014","journal-title":"Brain Inj."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.26603\/001c.87922","article-title":"The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic Review","volume":"18","author":"Kakavas","year":"2023","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1177\/03635465980260031601","article-title":"Concussion History in Elite Male and Female Soccer Players","volume":"26","author":"Barnes","year":"1998","journal-title":"Am. J. Sports Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1186\/s13018-021-02711-z","article-title":"Ball heading and subclinical concussion in soccer as a risk factor for anterior cruciate ligament injury","volume":"16","author":"Kakavas","year":"2021","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"365","DOI":"10.3109\/00016487609119974","article-title":"Voluntary, non-visual control of the human vestibulo-ocular reflex","volume":"81","author":"Barr","year":"1976","journal-title":"Acta Oto-Laryngol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/j.0006-341X.2000.00455.x","article-title":"Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis","volume":"56","author":"Duval","year":"2000","journal-title":"Biometrics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.msksp.2019.04.004","article-title":"History of concussion and risk of subsequent injury in athletes and service members: A systematic review and meta-analysis","volume":"42","author":"Reneker","year":"2019","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1177\/036354658601400114","article-title":"Strain within the anterior cruciate ligament during hamstring and quadriceps activity","volume":"14","author":"Arms","year":"1986","journal-title":"Am. J. Sports Med."},{"key":"ref_27","first-page":"91","article-title":"Neuropsychological testing of high school athletes. Preliminary norms and test-retest indices","volume":"18","author":"Barr","year":"2003","journal-title":"Arch. Clin. Neuropsychol. Off. J. Natl. Acad. Neuropsychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4085\/1062-6050-44.1.33","article-title":"The relationships among sagittal-plane lower extremity moments: Implications for landing strategy in anterior cruciate ligament injury prevention","volume":"44","author":"Shimokochi","year":"2009","journal-title":"J. Athl. Train."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"58","DOI":"10.3109\/02699052.2011.608216","article-title":"Measuring brain electrical activity to track recovery from sport-related concussion","volume":"26","author":"Barr","year":"2012","journal-title":"Brain Inj."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.4085\/1062-6050-50.10.08","article-title":"Brains and sprains: The brain\u2019s role in noncontact anterior cruciate ligament injuries","volume":"50","author":"Swanik","year":"2015","journal-title":"J. Athl. Train."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1053\/apmr.2003.50034","article-title":"An assessment of gait and balance deficits after traumatic brain injury","volume":"84","author":"Basford","year":"2003","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1177\/0363546507299532","article-title":"The relationship between neurocognitive function and noncontact anterior cruciate ligament injuries","volume":"35","author":"Swanik","year":"2007","journal-title":"Am. J. Sports Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1177\/0363546516635639","article-title":"Clinical Practices in Collegiate Concussion Management","volume":"44","author":"Baugh","year":"2016","journal-title":"Am. J. Sports Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1123\/ijatt.17.6.4","article-title":"Neurocognitive reaction time predicts lower extremity sprains and strains","volume":"17","author":"Wilkerson","year":"2012","journal-title":"Int. J. Athl. Ther. Train."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"866","DOI":"10.4085\/1062-6050-266-17","article-title":"Sport-related concussion: Knowledge and reporting behaviors among collegiate club-sport athletes","volume":"53","author":"Beidler","year":"2018","journal-title":"J. Athl. Train."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1177\/1941738111403122","article-title":"Systematic review of the balance error scoring system","volume":"3","author":"Bell","year":"2011","journal-title":"Sports Health"}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/9\/2\/65\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:24:23Z","timestamp":1760106263000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/9\/2\/65"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,7]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jfmk9020065"],"URL":"https:\/\/doi.org\/10.3390\/jfmk9020065","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,7]]}}}