2D video analysis of 90° change of direction using CMAS table: hip muscle injury

Introduction

Excessive trunk and pelvic motion in the frontal plane is implicated in various clinical conditions, including injuries to hip musculotendinous structures due to poor joint biomechanics and weak neuromuscular control. 2D video analysis can represent a valid alternative to 3D analysis (1), especially for evaluating specific movements such as accelerations, decelerations and changes of direction. This study evaluates the effectiveness of a 2D video analysis combined with the use of the Cutting Movement Assessment Score Tool (CMAS) (2) for daily rehabilitation practice associated with optimal workload management in a patient with acute right long adductor muscle injury. The anamnesis of the patient revealed five injuries in the last nine months.

AIM

This study investigates the relationship between change of direction (COD) movement quality and hip muscle injuries, specifically focusing on acute right long adductor muscle injuries.

Methods

The patient, male, 28 years old, amateur central defender in the fifth division of the Italian soccer league;
HAGOS questionnaire;
Maximum voluntary isometric contraction (MVIC), strenght test of hip adduction, hip abduction, knee extension at 60°, knee flexion at 45°. Baseline and 3 months after rehabilitation and On-field rehabilitation (OFR). Measured with an automatic device (Tindeq dynamometer);
2D video analysis with CMAS tool, (before and after rehabilitation and OFR). The video analysis was performed using two Logitech C922 720p/60fps cameras (Logitech International), and Microgate Optojump software (Microgate Italia, Bolzano, Italy);
The duration of the program was 3 months, and after the second month the indoor training was combined with OFR, for a total of 5 weekly workouts, 2 supervised workouts in the gym lasting about 90′ and 3 workouts at unsupervised field training but with directions.

Results

The results obtained demonstrated the efficacy of a planned training focused on the improvement of the quality of the movement, and the validity and the reliability of the CMAS score tool were confirmed.

Conclusions

The combination of CMAS and video analysis should be considered not only for the rehabilitation process of the anterior cruciate ligament in order to improve the rehabilitation and facilitate the return-to-play process. In our case, after the reconditioning process the athlete did not suffer any other injury in the following 20 weeks of follow-up, consisting of 4 weeks of training with the team and 16 weeks of RTP.

Reference

1. Della Villa F. et al. A 2D video-analysis scoring system of 90° change of direction technique identifies football players with high knee abduction moment. Knee Surgery, Sports Traumatology, Arthroscopy. 2022 Nov 29;30(11):3616–25;
2. Dos’Santos T, McBurnie A, Donelon T, Thomas C, Comfort P, Jones PA. A qualitative screening tool to identify athletes with ‘high-risk’ movement mechanics durin cutting: The cutting movement assessment score (CMAS). Physical Therapy in Sport. 2019 Jul;38:152–6.