Monday, January 6, 2020

Make 2020 The Year Of Change - Part II

Last week we started the discussion around some current research projects we have going on around the US.  In this series we are going to highlight three specific studies we have going on at the Division I level.  All of these studies are IRB approved.  Why Division I?  There are several reasons for this:
  • Access - with many of our relationships, this allows us access to this level of athlete.  With that, we can include our baseline movement testing as a part of their pre-season physicals fairly easily. 
  • Maturity - Division I athletes who are there on scholarship take their sport very seriously.  As such they are much more likely to put forth a solid effort needed during the assessment.
  • Tracking - at this level we can track injury rates through the athletic trainers EMR (electronic medical record) as well as claim submissions.  This allows us to track injuries but also track costs associated with.
  • Compliance - athletes at this level tend to be more compliant with the recommendations we give.
Secondly, we have a very standardized process we go through with all the athletes.  We first put each athlete through a standardized sequence of movements and based on the results, we then assign them to a standardized sequence of movement specific exercises.

For the movement assessment, each athlete is fit with a 3D sensors (provided by DorsaVi).  These sensors have an IMU (inertial measurement unit) inside that has an accelerometer, gyrometer and magnitometer.  This measures motion, rotation and acceleration data during any movement.  With these sensors, we are able to measure motion or stability within 3% of a Viacom system for spinal motion and knee motion.  

During the test, the athlete will perform three core tests, one bilateral test and 4 single limb tests.  During the core tests, the sensors will measure the athletes ability to maintain stability of the core within 10 degrees of flexion and extension and rotation.  During the bilateral tests, the sensor will provide the degree of lumbar flexion and lateral shift (how much the hips move during the motion).  In the single limb tests, the sensors provide us with the magnitude of frontal plane motion (varus and valgus) and the speed of frontal plane motion.  At the conclusion of the test, the system will provide with an automated report of all this data.  

As cumbersome and time consuming as this may sound, this process takes ~16 minutes per athlete.  In one of our largest data captures, we collected movement data on 400 athletes over a 4 day period and were assessing 109 athletes per day.  So, from an efficiency standpoint, this is a very efficient process.  

The movement test itself is exhausting.  It consists of 83 repetitions and 3 one minute timed tests.  It is an athletic exam and therefore we feel must be athletically demanding.  All of the single limb tests are first performed on the right side then the left side.  This allows to build up fatigue on one side through the completion of the tests followed by the contralateral side.  

Once the report is generated, we then assign each athlete to one of four levels on the ACL Play It Safe Program.  This is a program that we designed specifically to improve performance on the tests that we are testing.  We hypothesized that if we improved performance on the tests we were assessing that we would see an impact on injury rates and athletic performance.  And that is exactly what we are seeing.  

Next week we will get into some of the specific results and studies.  But I want all to realize, this is not just for Division I athletes.  This is for any and all athletes.  The ACL Play It Safe Program will not only reduce injury risk for all lower kinetic chain injuries but we are showing that it also improves vertical jump and sprint speed.  Best of all, it is free.  Simply download the app on IOS or Android and get a video of each exercise included as a part of the program.  Download it today and start impacting your athlete's performance.  

Stay tuned next week as we start to discuss the first of the two studies.  #ViPerformAMI #ACLPlayItSafe  Help us ring in 2020 right by spreading the word and helping to prevent athletic injuries. If you enjoy this blog, please share with your colleagues, athletes and training partners and please be sure to follow us on Instagram @ bjjpt_acl_guy and twitter @acl_prevention so we can continue to share some of the latest news.  If you happen to be at APTA Combined Sections this year, please come by and see us Thursday where we will be presenting on RTSport Following ACLR.  Train hard and stay well.   

Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment and ACL injury prevention.  He is the founder | developer of the ViPerform AMI,  ViPerform AMI RTPlay, the ACL Play It Safe Program, Run Safe Program and author of a college textbook on this subject.  Trent has performed >5000 athletic movement assessments in the US and abroad.  He serves as the National Director of Sports Medicine Innovation for Select Medical, is Vice Chairman of Medical Services for USA Obstacle Racing and movement consultant for numerous colleges and professional teams.  Trent also a Brazilian Jiu Jitsu purple belt and complete BJJ/MMA junkie. 

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