{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:03:34Z","timestamp":1792202614855,"version":"4.4.0"},"reference-count":42,"publisher":"National Athletic Trainers' Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context:<\/jats:title>\n                  <jats:p>Noncontact anterior cruciate ligament injury has been reported to occur during the later stages of a game when fatigue is most likely present. Few researchers have focused on progressive changes in lower extremity biomechanics that occur throughout fatiguing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To evaluate the effects of a sequential fatigue protocol on lower extremity biomechanics during a sidestep-cutting task (SS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Controlled laboratory study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting:<\/jats:title>\n                  <jats:p>Laboratory.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants:<\/jats:title>\n                  <jats:p>Eighteen uninjured female collegiate soccer players (age = 19.2 \u00b1 0.9 years, height = 1.66 \u00b1 0.5 m, mass = 61.6 \u00b1 5.1 kg) volunteered.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention(s):<\/jats:title>\n                  <jats:p>The independent variable was fatigue level, with 3 levels (prefatigue, 50% fatigue, and 100% fatigue). Using 3-dimensional motion capture, we assessed lower extremity biomechanics during the SS. Participants alternated between a fatigue protocol that solicited different muscle groups and mimicked actual sport situations and unanticipated SS trials. The process was repeated until fatigue was attained.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s):<\/jats:title>\n                  <jats:p>Dependent variables were hip- and knee-flexion and abduction angles and internal moments measured at initial contact and peak stance and defined as measures obtained between 0% and 50% of stance phase.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Knee-flexion angle decreased from prefatigue (\u221217\u00b0 \u00b1 5\u00b0) to 50% fatigue (\u221216\u00b0 \u00b1 6\u00b0) and to 100% fatigue (\u221214\u00b0 \u00b1 4\u00b0) (F2,34 = 5.112, P = .004). Knee flexion at peak stance increased from prefatigue (\u221252.9\u00b0 \u00b1 5.6\u00b0) to 50% fatigue (\u221256.1\u00b0 \u00b1 7.2\u00b0) but decreased from 50% to 100% fatigue (\u221250.5\u00b0 \u00b1 7.1\u00b0) (F2,34 = 8.282, P = 001). Knee-adduction moment at peak stance increased from prefatigue (0.49 \u00b1 0.23 Nm\/kgm) to 50% fatigue (0.55 \u00b1 0.25 Nm\/kgm) but decreased from 50% to 100% fatigue (0.37 \u00b1 0.24) (F2,34 = 3.755, P = 03). Hip-flexion angle increased from prefatigue (45.4\u00b0 \u00b1 10.9\u00b0) to 50% fatigue (46.2\u00b0 \u00b1 11.2\u00b0) but decreased from 50% to 100% fatigue (40.9\u00b0 \u00b1 11.3\u00b0) (F2,34 = 6.542, P = .004). Hip flexion at peak stance increased from prefatigue (49.8\u00b0 \u00b1 9.9\u00b0) to 50% fatigue (52.9\u00b0 \u00b1 12.1\u00b0) but decreased from 50% to 100% fatigue (46.3\u00b0 \u00b1 12.9\u00b0) (F2,34 = 8.639, P = 001). Hip-abduction angle at initial contact decreased from prefatigue (\u221213.8\u00b0 \u00b1 6.6\u00b0) to 50% fatigue (\u22129.1\u00b0 \u00b1 6.5\u00b0) and to 100% fatigue (\u22127.8\u00b0 \u00b1 6.5\u00b0) (F2,34 = 11.228, P &amp;lt; .001). Hip-adduction moment decreased from prefatigue (0.14 \u00b1 0.13 Nm\/kgm) to 50% fatigue (0.08 \u00b1 0.13 Nm\/kgm) and to 100% fatigue (0.06 \u00b1 0.05 Nm\/kg) (F2,34 = 5.767, P = .007).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>The detrimental effects of fatigue on sagittal and frontal mechanics of the hip and knee were visible at 50% of the participants' maximal fatigue and became more marked at 100% fatigue. Anterior cruciate ligament injury-prevention programs should emphasize feedback on proper mechanics throughout an entire practice and not only at the beginning of practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-48.2.03","type":"journal-article","created":{"date-parts":[[2013,5,15]],"date-time":"2013-05-15T19:25:21Z","timestamp":1368645921000},"page":"306-313","source":"Crossref","is-referenced-by-count":51,"title":["Changes in Lower Extremity Biomechanics Due to a Short-Term Fatigue Protocol"],"prefix":"10.4085","volume":"48","author":[{"given":"Nelson","family":"Cortes","sequence":"first","affiliation":[{"name":"Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Greska","sequence":"first","affiliation":[{"name":"Human Movement Sciences, Old Dominion University, Norfolk, VA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Kollock","sequence":"first","affiliation":[{"name":"Human Movement Sciences, Old Dominion University, Norfolk, VA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jatin","family":"Ambegaonkar","sequence":"first","affiliation":[{"name":"Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Onate","sequence":"first","affiliation":[{"name":"School of Allied Medical Professions, The Ohio State University, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"1","key":"2020060411110952200_i1062-6050-48-3-306-b01","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.clinbiomech.2007.08.008","article-title":"Combined effects of fatigue and decision making on female lower limb landing postures: central and peripheral contributions to ACL injury risk","volume":"23","author":"Borotikar","year":"2008","journal-title":"Clin Biomech (Bristol, Avon)"},{"issue":"8","key":"2020060411110952200_i1062-6050-48-3-306-b02","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1249\/MSS.0b013e31819ca07b","article-title":"Fatigue-induced ACL injury risk stems from a degradation in central control","volume":"41","author":"McLean","year":"2009","journal-title":"Med Sci Sports Exerc"},{"issue":"4","key":"2020060411110952200_i1062-6050-48-3-306-b03","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1136\/bjsm.2004.011973","article-title":"Injuries in women's professional soccer","volume":"39","author":"Giza","year":"2005","journal-title":"Br J Sports Med"},{"issue":"1","key":"2020060411110952200_i1062-6050-48-3-306-b04","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/bjsm.35.1.43","article-title":"The association football medical research programme: an audit of injuries in professional football","volume":"35","author":"Hawkins","year":"2001","journal-title":"Br J Sports Med"},{"issue":"2","key":"2020060411110952200_i1062-6050-48-3-306-b05","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1177\/0363546507307866","article-title":"Injuries in young elite female soccer players: an 8-season prospective study","volume":"36","author":"Le Gall","year":"2008","journal-title":"Am J Sports Med"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b06","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1249\/mss.0b013e3180d47f0","article-title":"Impact of fatigue on gender-based high-risk landing strategies","volume":"39","author":"McLean","year":"2007","journal-title":"Med Sci Sports Exerc"},{"issue":"6","key":"2020060411110952200_i1062-6050-48-3-306-b07","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1177\/0363546508314425","article-title":"Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks","volume":"36","author":"Chappell","year":"2008","journal-title":"Am J Sports Med"},{"issue":"4","key":"2020060411110952200_i1062-6050-48-3-306-b08","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1177\/0363546504269591","article-title":"Neuromuscular control and valgus loading of the knee predict ACL injury risk in female athletes","volume":"33","author":"Hewett","year":"2005","journal-title":"Am J Sports Med"},{"issue":"7","key":"2020060411110952200_i1062-6050-48-3-306-b09","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1177\/0363546504273047","article-title":"Effect of fatigue on knee kinetics and kinematics in stop-jump tasks","volume":"33","author":"Chappell","year":"2005","journal-title":"Am J Sports Med"},{"issue":"9","key":"2020060411110952200_i1062-6050-48-3-306-b10","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1177\/0363546506286866","article-title":"Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005","volume":"34","author":"Griffin","year":"2006","journal-title":"Am J Sports Med"},{"issue":"5","key":"2020060411110952200_i1062-6050-48-3-306-b11","doi-asserted-by":"crossref","first-page":"499","DOI":"10.4085\/1062-6050-45.5.499","article-title":"ACL Research Retreat V: an update on ACL injury risk and prevention, March 25\u201327, 2010, Greensboro, NC","volume":"45","author":"Shultz","year":"2010","journal-title":"J Athl Train"},{"issue":"4","key":"2020060411110952200_i1062-6050-48-3-306-b12","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1177\/0363546503261724","article-title":"Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis","volume":"32","author":"Olsen","year":"2004","journal-title":"Am J Sports Med"},{"issue":"10","key":"2020060411110952200_i1062-6050-48-3-306-b13","doi-asserted-by":"crossref","first-page":"2381","DOI":"10.2106\/JBJS.H.01721","article-title":"Tibiofemoral alignment: contributing factors to noncontact anterior cruciate ligament injury","volume":"91","author":"Boden","year":"2009","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"2020060411110952200_i1062-6050-48-3-306-b14","doi-asserted-by":"crossref","first-page":"573","DOI":"10.3928\/0147-7447-20000601-15","article-title":"Mechanisms of anterior cruciate ligament injury","volume":"23","author":"Boden","year":"2000","journal-title":"Orthopedics"},{"issue":"4","key":"2020060411110952200_i1062-6050-48-3-306-b15","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"},{"issue":"suppl 1","key":"2020060411110952200_i1062-6050-48-3-306-b16","doi-asserted-by":"crossref","first-page":"i47","DOI":"10.1136\/bjsm.2007.037192","article-title":"Mechanisms of non-contact ACL injuries","volume":"41","author":"Yu","year":"2007","journal-title":"Br J Sports Med"},{"issue":"11","key":"2020060411110952200_i1062-6050-48-3-306-b17","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1177\/0363546510373570","article-title":"Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball","volume":"38","author":"Koga","year":"2010","journal-title":"Am J Sports Med"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b18","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1177\/0363546506293899","article-title":"Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases","volume":"35","author":"Krosshaug","year":"2007","journal-title":"Am J Sports Med"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b19","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1177\/0363546507308934","article-title":"Gender differences in lower extremity landing mechanics caused by neuromuscular fatigue","volume":"36","author":"Kernozek","year":"2008","journal-title":"Am J Sports Med"},{"issue":"11","key":"2020060411110952200_i1062-6050-48-3-306-b20","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1177\/0363546507300823","article-title":"Neuromuscular and lower limb biomechanical differences exist between male and female elite adolescent soccer players during an unanticipated side-cut maneuver","volume":"35","author":"Landry","year":"2007","journal-title":"Am J Sports Med"},{"issue":"7","key":"2020060411110952200_i1062-6050-48-3-306-b21","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/j.clinbiomech.2008.03.065","article-title":"Fatigue-related changes in stance leg mechanics during sidestep cutting maneuvers","volume":"23","author":"Sanna","year":"2008","journal-title":"Clin Biomech (Bristol, Avon)"},{"issue":"1","key":"2020060411110952200_i1062-6050-48-3-306-b22","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1080\/14763141.2010.547591","article-title":"Soccer-specific video simulation for improving movement assessment","volume":"10","author":"Cortes","year":"2011","journal-title":"Sports Biomech"},{"issue":"1","key":"2020060411110952200_i1062-6050-48-3-306-b23","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1080\/02640414.2010.523087","article-title":"Pivot task increases knee frontal plane loading compared with sidestep and drop-jump","volume":"29","author":"Cortes","year":"2011","journal-title":"J Sports Sci"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b24","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1519\/JSC.0b013e3181cc23c3","article-title":"Psychological correlates of performance in female athletes during a 12-week off-season strength and conditioning program","volume":"24","author":"Jones","year":"2010","journal-title":"J Strength Cond Res"},{"issue":"5","key":"2020060411110952200_i1062-6050-48-3-306-b25","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1097\/mss.0b013e31803349c6","article-title":"Longitudinal modeling of the relationship between age and maximal heart rate","volume":"39","author":"Gellish","year":"2007","journal-title":"Med Sci Sports Exerc"},{"issue":"1","key":"2020060411110952200_i1062-6050-48-3-306-b26","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4085\/1062-6050-47.1.32","article-title":"Two different fatigue protocols and lower extremity motion patterns during a stop-jump task","volume":"47","author":"Quammen","year":"2012","journal-title":"J Athl Train"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b27","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.gaitpost.2006.04.010","article-title":"Effects of movement for estimating the hip joint centre","volume":"25","author":"Begon","year":"2007","journal-title":"Gait Posture"},{"issue":"1","key":"2020060411110952200_i1062-6050-48-3-306-b28","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jbiomech.2004.03.009","article-title":"A new method for estimating joint parameters from motion data","volume":"38","author":"Schwartz","year":"2005","journal-title":"J Biomech"},{"issue":"2","key":"2020060411110952200_i1062-6050-48-3-306-b29","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0021-9290(98)00158-4","article-title":"Bone position estimation from skin marker co-ordinates using global optimisation with joint constraints","volume":"32","author":"Lu","year":"1999","journal-title":"J Biomech"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b30","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1123\/jab.15.3.318","article-title":"Estimate of the optimum cutoff frequency for the Butterworth low-pass digital filter","volume":"15","author":"Yu","year":"1999","journal-title":"J Appl Biomech"},{"key":"2020060411110952200_i1062-6050-48-3-306-b31","article-title":"Space Requirements of the Seated Operator: Geometrical, Kinematic, and Mechanical Aspects of the Body, With Special Reference to the Limbs","author":"Dempster","year":"1955","journal-title":"Wright Air Development Center"},{"key":"2020060411110952200_i1062-6050-48-3-306-b32","unstructured":"Winter\n              DA . \n          \n          Biomechanics and Motor Control of Human Movement. 3rd ed . Hoboken, NJ : John Wiley & Sons Inc;2005 :75 \u2013102 ."},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b33","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.clinbiomech.2007.10.003","article-title":"Influence of trunk flexion on hip and knee joint kinematics during a controlled drop landing","volume":"23","author":"Blackburn","year":"2008","journal-title":"Clin Biomech (Bristol, Avon)"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b34","doi-asserted-by":"crossref","first-page":"171","DOI":"10.2519\/jospt.1997.25.3.171","article-title":"The effect of quadriceps femoris, hamstring, and placebo eccentric fatigue on knee and ankle dynamics during crossover cutting","volume":"25","author":"Nyland","year":"1997","journal-title":"J Orthop Sports Phys Ther"},{"issue":"5","key":"2020060411110952200_i1062-6050-48-3-306-b35","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s00167-003-0403-6","article-title":"In vivo anterior cruciate ligament strain behaviour during a rapid deceleration movement: case report","volume":"11","author":"Cerulli","year":"2003","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"6","key":"2020060411110952200_i1062-6050-48-3-306-b36","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1002\/jor.1100130618","article-title":"Combined knee loading states that generate high anterior cruciate ligament forces","volume":"13","author":"Markolf","year":"1995","journal-title":"J Orthop Res"},{"issue":"4","key":"2020060411110952200_i1062-6050-48-3-306-b37","doi-asserted-by":"crossref","first-page":"557","DOI":"10.2106\/00004623-199072040-00014","article-title":"Direct measurement of resultant forces in the anterior cruciate ligament: an in vitro study performed with a new experimental technique","volume":"72","author":"Markolf","year":"1990","journal-title":"J Bone Joint Surg Am"},{"issue":"9","key":"2020060411110952200_i1062-6050-48-3-306-b38","doi-asserted-by":"crossref","first-page":"520","DOI":"10.5435\/00124635-201009000-00003","article-title":"Noncontact anterior cruciate ligament injuries: mechanisms and risk factors","volume":"18","author":"Boden","year":"2010","journal-title":"J Am Acad Orthop Surg"},{"issue":"10","key":"2020060411110952200_i1062-6050-48-3-306-b39","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/S0021-9290(97)00070-5","article-title":"Dependence of cruciate-ligament loading on muscle forces and external load","volume":"30","author":"Pandy","year":"1997","journal-title":"J Biomech"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b40","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.clinbiomech.2005.11.003","article-title":"Lower extremity biomechanics during the landing of a stop-jump task","volume":"21","author":"Yu","year":"2006","journal-title":"Clin Biomech (Bristol, Avon)"},{"issue":"3","key":"2020060411110952200_i1062-6050-48-3-306-b41","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/036354659202000311","article-title":"Anterior-posterior and rotational displacement of the tibia elicited by quadriceps contraction","volume":"20","author":"Hirokawa","year":"1992","journal-title":"Am J Sports Med"},{"issue":"2","key":"2020060411110952200_i1062-6050-48-3-306-b42","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1080\/02701367.1998.10607676","article-title":"Knowledge is more than we can talk about: implicit learning in motor skill acquisition","volume":"69","author":"Magill","year":"1998","journal-title":"Res Q Exerc Sport"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/48\/3\/306\/1608963\/1062-6050-48_2_03.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/48\/3\/306\/1608963\/1062-6050-48_2_03.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T18:57:34Z","timestamp":1749668254000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/48\/3\/article-p306.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,1]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,5,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-48.2.03","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2013,5,1]]}}}