Athletic groin pain (part 2): a prospective cohort study on the biomechanical evaluation of change of direction identifies three clusters of movement patterns

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dc.contributor.authorFranklyn-Miller, Andrew
dc.contributor.authorRichter, Chris
dc.contributor.authorKing, Enda
dc.contributor.authorGore, S.
dc.contributor.authorMoran, Kieran A.
dc.contributor.authorStrike, S.
dc.contributor.authorFalvey, Éanna
dc.contributor.funderScience Foundation Irelanden
dc.contributor.funderSports Surgery Clinic (SSC), Dublin, Irelanden
dc.contributor.funderDublin City University
dc.date.accessioned2016-10-28T11:12:38Z
dc.date.available2016-10-28T11:12:38Z
dc.date.issued2016-10-08
dc.description.abstractBackground: Athletic groin pain (AGP) is prevalent in sports involving repeated accelerations, decelerations, kicking and change-of-direction movements. Clinical and radiological examinations lack the ability to assess pathomechanics of AGP, but three-dimensional biomechanical movement analysis may be an important innovation. Aim: The primary aim was to describe and analyse movements used by patients with AGP during a maximum effort change-of-direction task. The secondary aim was to determine if specific anatomical diagnoses were related to a distinct movement strategy. Methods: 322 athletes with a current symptom of chronic AGP participated. Structured and standardised clinical assessments and radiological examinations were performed on all participants. Additionally, each participant performed multiple repetitions of a planned maximum effort change-of-direction task during which whole body kinematics were recorded. Kinematic and kinetic data were examined using continuous waveform analysis techniques in combination with a subgroup design that used gap statistic and hierarchical clustering. Results: Three subgroups (clusters) were identified. Kinematic and kinetic measures of the clusters differed strongly in patterns observed in thorax, pelvis, hip, knee and ankle. Cluster 1 (40%) was characterised by increased ankle eversion, external rotation and knee internal rotation and greater knee work. Cluster 2 (15%) was characterised by increased hip flexion, pelvis contralateral drop, thorax tilt and increased hip work. Cluster 3 (45%) was characterised by high ankle dorsiflexion, thorax contralateral drop, ankle work and prolonged ground contact time. No correlation was observed between movement clusters and clinically palpated location of the participant's pain. Conclusions: We identified three distinct movement strategies among athletes with long-standing groin pain during a maximum effort change-of-direction task. These movement strategies were not related to clinical assessment findings but highlighted targets for rehabilitation in response to possible propagative mechanisms. Trial registration number NCT02437942, pre results.en
dc.description.sponsorshipScience Foundation Ireland (SFI grant number SFI/12/RC/2289); Dublin City University (Insight Centre for Data Analytics)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationFranklyn-Miller, A., Richter, C., King, E., Gore, S., Moran, K., Strike, S. and Falvey, E. C. (2016) ‘Athletic groin pain (part 2): a prospective cohort study on the biomechanical evaluation of change of direction identifies three clusters of movement patterns’, British Journal of Sports Medicine. Published Online First: 6 October 2016. doi:10.1136/bjsports-2016-096050en
dc.identifier.doi10.1136/bjsports-2016-096050
dc.identifier.issn0306-3674
dc.identifier.journaltitleBritish Journal of Sports Medicineen
dc.identifier.urihttps://hdl.handle.net/10468/3223
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.rights© Article authors (or their employer) 2016. Produced by BMJ Publishing Group Ltd under licence. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/en
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectSports medicineen
dc.subjectAthletic groin pain (AGP)en
dc.subjectAthletic injuriesen
dc.subjectSports injuriesen
dc.subjectPathomechanicsen
dc.subjectMovement strategiesen
dc.subjectAthletesen
dc.titleAthletic groin pain (part 2): a prospective cohort study on the biomechanical evaluation of change of direction identifies three clusters of movement patternsen
dc.typeArticle (peer-reviewed)en
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