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Completed

NCT Number: NCT07608575

Trunk and Lower Limb Muscle Contributions to ACL Loading During Single-Leg Landing

Anterior cruciate ligament (ACL) injuries commonly occurred through non-contact mechanisms during dynamic tasks such as single-leg landing (SLL). Trunk control and lower limb muscle coordination were believed to play a critical role in modulating knee joint biomechanics and ACL loading; however, their individual muscle contributions remained poorly understood due to the difficulty of in-vivo ACL force measurement. This cross-sectional study aimed to investigate the relationship between core strength, lower limb muscle forces, knee joint biomechanics, and ACL loading during single-leg landing in collegiate athletes. Three-dimensional full-body kinematics, ground reaction forces, and electromyography data were collected and integrated into a musculoskeletal modelling framework to estimate ACL loading and individual muscle force contributions. Findings from this study were expected to provide biomechanical evidence to support targeted injury-prevention and rehabilitation strategies.

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Key information

Conditions

ACL

Age range

19 year–25 year

Sex eligibility

Male

Study type

Observational

Primary location

School of Mechanical Engineering, Universiti Sains Malaysia

Nibong Tebal, Pulau Pinang, Malaysia

About this study

Anterior cruciate ligament injuries often led to long-term consequences including early knee osteoarthritis, abnormal neuromuscular function, and reduced athletic participation. Approximately 70% of ACL injuries occurred via non-contact mechanisms, frequently during single-leg landing tasks. During such movements, ACL loading was influenced by joint kinematics, external forces, and neuromuscular coordination of both trunk and lower limb muscles. This study adopted a two-level approach. First, standard biomechanical analyses were conducted to evaluate the relationship between functional core strength and knee joint biomechanics, including knee valgus angle and knee abduction moment during SLL. Second, a musculoskeletal modelling approach was employed to quantify the contribution of individual trunk and lower limb muscles to ACL loading.

Participants performed standardized single-leg landing tasks while wearing inertial motion sensors and surface electromyography electrodes. Ground reaction forces were recorded using a force platform. A full-body musculoskeletal model was scaled to participant anthropometry and used to estimate muscle forces and ACL loading during the landing phase. Statistical analyses included linear regression and linear mixed-effects modelling to examine relationships between muscle forces, knee biomechanics, and ACL loading.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male collegiate athletes aged 19-25 years
  • Minimum of 3 years of competitive experience in jump-landing sports (e.g., volleyball, basketball, netball)
  • Training frequency of at least twice per week
  • No history of back or lower limb injury

Exclusion criteria

  • History of major lower limb or back injury requiring surgery
  • Any medical condition preventing maximal physical effort
  • Current musculoskeletal pain or injury affecting movement performance

Treatment and study plan

Primary outcomes

  1. Peak Anterior Cruciate Ligament (ACL) Force During Single-Leg Landing

    Time frame: Assessed during a single laboratory testing session (up to 2 hours).

    Peak anterior cruciate ligament (ACL) force (Newtons, N) was estimated during the landing phase of a single-leg landing task using subject-specific musculoskeletal modelling. Three-dimensional whole-body kinematics (Xsens inertial motion capture), ground reaction forces (Bertec force platform), and surface electromyography (EMG) signals from trunk and lower limb muscles were integrated within a full-body musculoskeletal model to compute ACL loading. Peak ACL force was extracted from initial ground contact to maximum knee flexion.

  2. Correlation Between Plank Endurance Time and Peak Knee Valgus Angle During Single-Leg Landing

    Time frame: Assessed during a single laboratory testing session (up to 2 hours).

    Pearson correlation between plank endurance time (seconds) and peak knee valgus angle (degrees) measured during single-leg landing using three-dimensional motion analysis (Xsens inertial motion capture).

  3. Knee Valgus Angle During Single-Leg Landing

    Time frame: Assessed during a single laboratory testing session (up to 2 hours).

    Peak knee valgus angle (degrees, °) was calculated from three-dimensional lower limb kinematic data collected using full-body inertial motion capture (Xsens). Knee joint angles were derived using inverse kinematics and analyzed from initial ground contact to maximum knee flexion during the single-leg landing task.

  4. Knee Abduction Moment During Single-Leg Landing

    Time frame: Assessed during a single laboratory testing session (up to 2 hours).

    Peak knee abduction moment (Newton-meters, Nm) was computed using inverse dynamics based on synchronized three-dimensional kinematic data (Xsens) and ground reaction force data (Bertec force platform). Peak values were identified during the landing phase from initial ground contact to maximum knee flexion.

  5. Trunk and Lower Limb Muscle Forces During Single-Leg Landing

    Time frame: Assessed during a single laboratory testing session (up to 2 hours).

    Peak trunk and lower limb muscle forces (Newtons, N) were estimated using a full-body lumbar spine musculoskeletal model driven by experimental kinematics, ground reaction forces, and electromyography-informed muscle activation patterns. Muscle force outputs were analyzed during the landing phase of the single-leg landing task from initial ground contact to maximum knee flexion.

Sponsors and collaborators

Lead sponsor

Universiti Sains Malaysia

Other

Registry information

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
May 27, 2026
Registry last updated
May 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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