{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:25:16Z","timestamp":1792441516943,"version":"4.5.0"},"reference-count":40,"publisher":"National Athletic Trainers' Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context:<\/jats:title>\n                  <jats:p>Knee laxity increases during exercise. However, no one, to our knowledge, has examined whether these increases contribute to higher-risk landing biomechanics during prolonged, fatiguing exercise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives:<\/jats:title>\n                  <jats:p>To examine associations between changes in fatigue (measured as sprint time [SPTIME]), multiplanar knee laxity (anterior-posterior [APLAX], varus-valgus [VVLAX] knee laxity, and internal-external rotation [IERLAX]) knee laxity and landing biomechanics during prolonged, intermittent exercise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Descriptive laboratory study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting:<\/jats:title>\n                  <jats:p>Laboratory and gymnasium.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants:<\/jats:title>\n                  <jats:p>A total of 30 male (age = 20.3 \u00b1 2.0 years, height = 1.79 \u00b1 0.05 m, mass = 75.2 \u00b1 7.2 kg) and 29 female (age = 20.5 \u00b1 2.3 years, height = 1.67 \u00b1 0.08 m, mass = 61.8 \u00b1 9.0 kg) competitive athletes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention(s):<\/jats:title>\n                  <jats:p>A 90-minute intermittent exercise protocol (IEP) designed to simulate the physiologic and biomechanical demands of a soccer match.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s):<\/jats:title>\n                  <jats:p>We measured SPTIME, APLAX, and landing biomechanics before and after warm-up, every 15 minutes during the IEP, and every 15 minutes for 1 hour after the IEP. We measured VVLAX and IERLAX before and after the warm-up, at 45 and 90 minutes during the IEP, and at 30 minutes after the IEP. We used hierarchical linear modeling to examine associations between exercise-related changes in SPTIME and knee laxity with exercise-related changes in landing biomechanics while controlling for initial (before warm-up) knee laxity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>We found that SPTIME had a more global effect on landing biomechanics in women than in men, resulting in a more upright landing and a reduction in landing forces and out-of-plane motions about the knee. As APLAX increased with exercise, women increased their knee internal-rotation motion (P = .02), and men increased their hip-flexion motion and energy-absorption (P = .006) and knee-extensor loads (P = .04). As VVLAX and IERLAX increased, women went through greater knee-valgus motion and dorsiflexion and absorbed more energy at the knee (P \u2264 .05), whereas men were positioned in greater hip external and knee internal rotation and knee valgus throughout the landing (P = .03). The observed fatigue- and laxity-related changes in landing biomechanics during exercise often depended on initial knee laxity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>Both exercise-related changes in fatigue and knee laxity were associated with higher-risk landing biomechanics during prolonged exercise. These relationships were more pronounced in participants with greater initial knee laxity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-49.5.08","type":"journal-article","created":{"date-parts":[[2015,2,12]],"date-time":"2015-02-12T17:59:39Z","timestamp":1423763979000},"page":"486-497","source":"Crossref","is-referenced-by-count":24,"title":["Changes in Fatigue, Multiplanar Knee Laxity, and Landing Biomechanics During Intermittent Exercise"],"prefix":"10.4085","volume":"50","author":[{"given":"Sandra J.","family":"Shultz","sequence":"first","affiliation":[{"name":"*Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy J.","family":"Schmitz","sequence":"additional","affiliation":[{"name":"*Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Cone","sequence":"additional","affiliation":[{"name":"\u2020Athletes' Research Institute Inc, Chapel Hill, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Henson","sequence":"additional","affiliation":[{"name":"\u2021School of Education, University of North Carolina at Greensboro;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa M.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"\u00a7Department of Kinesiology, California State University, Northridge;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele L.","family":"Pye","sequence":"additional","affiliation":[{"name":"*Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Tritsch","sequence":"additional","affiliation":[{"name":"\u2016Department of Orthopaedics and Sports Medicine, University of Florida, Tampa. Ms Pye is now at the Department of Kinesiology, University of Toledo, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","published-online":{"date-parts":[[2015,5,1]]},"reference":[{"key":"2024122012163133200_i1062-6050-50-5-486-b01","doi-asserted-by":"crossref","unstructured":"Branch\n              TP,\n            \n            \n              Browne\n              JE,\n            \n            \n              Campbell\n              JD,\n            \n            et al.\n          \n          Rotational laxity greater in patients with contralateral anterior cruciate ligament injury than healthy volunteers.\nKnee Surg Sports Traumatol Arthrosc.\n2010;\n18(10):\n1379\u20131384.","DOI":"10.1007\/s00167-009-1010-y"},{"key":"2024122012163133200_i1062-6050-50-5-486-b02","doi-asserted-by":"crossref","unstructured":"Scerpella\n              TA,\n            \n            \n              Stayer\n              TJ,\n            \n            \n              Makhuli\n  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Res.\n2006;\n24(3):\n516\u2013523","DOI":"10.1002\/jor.20040"},{"key":"2024122012163133200_i1062-6050-50-5-486-b08","doi-asserted-by":"crossref","unstructured":"Shultz\n              SJ,\n            \n            \n              Schmitz\n              RJ,\n            \n            \n              Nguyen\n              AD,\n            \n            et al.\n          \n          Knee laxity and its cyclic variations influence tibiofemoral joint motion during weight acceptance.\nMed Sci Sports Exerc.\n2011;\n43(2):\n287\u2013295.","DOI":"10.1249\/MSS.0b013e3181ed118d"},{"key":"2024122012163133200_i1062-6050-50-5-486-b09","doi-asserted-by":"crossref","unstructured":"Shultz\n              SJ,\n            \n            \n              Schmitz\n              RJ,\n            \n            \n              Nguyen\n              AD,\n            \n            \n              Levine\n              BJ.\n            \n          \n          Joint laxity is related to lower extremity energetics during a drop jump landing.\nMed Sci Sports Exerc.\n2010;\n42(4):\n771\u2013780.","DOI":"10.1249\/MSS.0b013e3181bbeaa6"},{"key":"2024122012163133200_i1062-6050-50-5-486-b10","doi-asserted-by":"crossref","unstructured":"Shultz\n              SJ,\n            \n            \n              Schmitz\n              RJ.\n            \n          \n          Effects of transverse and frontal plane knee laxity on hip and knee neuromechanics during drop landings.\nAm J Sports Med.\n2009;\n37(9):\n1821\u20131830.","DOI":"10.1177\/0363546509334225"},{"key":"2024122012163133200_i1062-6050-50-5-486-b11","doi-asserted-by":"crossref","unstructured":"Withrow\n              TJ,\n            \n            \n              Huston\n              LJ,\n            \n            \n              Wojtys\n              EM,\n            \n            \n              Ashton-Miller\n              JA.\n            \n          \n          The effect of an impulsive knee valgus moment on in vitro relative ACL strain 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