BJMB
Brazilian Journal of Motor Behavior
Special issue:
“Manipulation of sensory information on postural control
performance of children, young and older adults”
de Menezes
Cantusio et al.
2024
VOL.18
https://doi.org/10.20338/bjmb.v18i1.385
1 of 6
How the multiplanar trunk resistance affects the dynamic postural control during single-
leg vertical jumps in college athletes with poor movement quality
LAURA M. CANTUSIO
1
| RENÊ RIBEIRO
2
| MILTON S. MISUTA
2
| KARINE J. SARRO
1
1
Faculdade de Educação Física, Universidade Estadual de Campinas, Campinas, SP, Brazil
2
Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Campinas, SP, Brazil
Correspondence to: Karine Jacon Sarro
Universidade Estadual de Campinas, Faculdade de Educação Física - Av. Érico Veríssimo, 701 - Cidade Universitária "Zeferino Vaz" - CEP: 13.083-851 - Barão
Geraldo - Campinas - SP – Brazil
email: ksarro@unicamp.br
https://doi.org/10.20338/bjmb.v18i1.385
HIGHLIGHTS
• Multiplanar predictable trunk resistance during single-
leg jumps increases mediolateral displacement of the
center of pressure.
• Multiplanar trunk resistance affects postural control of
female athletes with poor movement quality even at low
intensity.
• It is recommended to assess movement quality before
incorporating training involving multiplanar trunk
resistance in jumps with female athletes.
ABBREVIATIONS
COP Center of pressure
COPap COP maximum displacement in the
anteroposterior direction
COPml COP maximum displacement in the
mediolateral direction
HipSIT Hip Stability Isometric Test
RMSap Root Mean Square in the anteroposterior
direction
RMSml Root Mean Square in the mediolateral
Direction
ROM Range of motion
SLS Single Leg Squat Test
Vap COP mean velocity in the anteroposterior
direction
Vml COP mean velocity in the mediolateral
direction
PUBLICATION DATA
Received 01 08 2023
Accepted 19 03 2024
Published 12 05 2024
BACKGROUND: Poor movement quality of the trunk and the lower limbs as well as dynamic
postural control have a strong relation with non-contact injuries in sport. Aiming to reduce the
risk of injuries, training approaches using loaded jumps with trunk resistance have been
proposed.
AIM: To describe how a multiplanar trunk load affects the dynamic postural control and the
peak vertical ground reaction force of college athletes with poor movement quality of the trunk
and the lower limbs.
METHOD: Center of Pressure (COP) variables and peak vertical ground reaction force of 24
female college athletes during single-leg jumps with and without a trunk resistance were
compared.
RESULTS: There was a significant decrease of the COP displacement (p=0.006), RMS
(p=0.009) and velocity (p=0.007) in the anteroposterior direction, and an increase of the COP
displacement (p=0.016), RMS (p=0.043) and velocity (p=0.043) in the mediolateral direction,
with a moderate effect size. No significant difference was found in the peak vertical ground
reaction force.
CONCLUSION: Exercises involving multiplanar trunk resistance may negatively impact
dynamic postural control in women with poor movement quality.
KEYWORDS: Center of pressure| Misalignments | Jump
INTRODUCTION
Single-leg landings and change of direction are common sports tasks that are related to severe lower limb injuries, such as
non-contact ACL injuries
1
. Studies have shown a strong relation between poor movement quality of the trunk and the lower limbs (such
as misalignment, excessive movement and imbalances
2,3
) and joint overload
4,5
. Additionally, another essential factor in situations where
non-contact injuries mainly occur is the dynamic postural control
6
. Considering that the incidence of non-contact injuries in sport is high,
there is a need for appropriate approaches for training and reducing injury risks.
While the exact knee injury mechanism involving the trunk and the lower limbs during jumps has not been identified, some
studies point that certain dynamic postures are strongly associated with acute or overuse injuries. These include pronounced lateral trunk
flexions, shallow trunk flexions, and significant trunk rotations during landing
5,7,8
.
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Special issue:
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Considering that 45% of the total body mass is concentrated in the trunk segment, strength deficits or a lack of adequate
neuromuscular control can lead to greater misalignment and excessive range of motion
9
, which can influence the position of the ground
reaction force and, consequently, the load in the knee
10
. Therefore, strategies aiming the improvement of segment alignment and
dynamic postural control should incorporate trunk resistance training during sports gestures. Additionally, Dischiavi et al.
4
indicate that
the trunk resistance should represent a multiplanar load, that is, applied simultaneously in the three movement planes to enhance force
transmission between the trunk segment and the lower limbs improving movement quality and approximating the exercise complexity to
the athletic demands.
However, it is widely recognized that simply developing neuromuscular capacities of strength and endurance does not
guarantee improvements in dynamic postural control or movement quality
10,11
. Therefore, it is essential that exercises include strategies
that encourage and stimulate these abilities. Although Dischiavi et al.
4
suggest a multiplanar resistance of the trunk to achieve these
goals, to the best of our knowledge, there is no study describing how a multiplanar trunk load affects dynamic postural control, which
would be an essential knowledge to understand the potential training applications of this kind of loading during jumps.
Therefore, the objective of this study was to describe the effects of multiplanar trunk resistance on dynamic postural control
during single-leg jumps in female college athletes with low-quality movement. We hypothesized that applying an external predictable
multiplanar load to the trunk during jumps would improve the dynamic postural control, possibly due to the increased muscular activation.
METHOD
Participants
A sample size of 28 subjects was calculated, based on an alpha error of 0.05, a power of 0.80, and an effect size of 0.25.
However, due to sample loss of four participants during the course of the study, the final sample consisted of 24 female college athletes
(defined as a student who is enrolled at an institution and is listed as a member of an intercollegiate athletics team at the institution)
12
.
They had the following characteristics: mean age of 20.54 ± 2.04 years; mean height of 1.62 ± 0.05m; mean body mass of 63.44 ±
8.47Kg; and was enrolled in team sports modalities (volleyball, handball, soccer, and basketball). All the participants signed the informed
consent form. The study was approved by the Human Research Ethics Committee (CAAE: 56427822.7.0000.5404).
The inclusion criteria was: sport practice at least twice a week for at least one year; participation in sports competitions; no
history of surgery, pain or injury in the lower limbs and the lumbar spine in the last 6 months, low quality movement during a Single Leg
Squat Test (SLS) (at least 2 points out of 4 in the validated and reliable score (ĸ = 0.82) for qualitative assessment of movement quality
proposed by Ressman et al.
2
).
To evaluate the quality of the movement, the participants performed three consecutive single-leg squats while an experienced
physical therapist observed and scored movement deviations from the vertical alignment of the body segments — foot, knee, pelvis, and
trunk. No deviation was scored as 0 points, and 1 point was attributed to the deviation of each segment. A deviation of one segment
could only be scored once (one point), even if it occurred in all three squats. Thus, the total score for the multi-segmental SLS test could
range from 0 to a maximum of 4 points.
Data Collection
Participants were assessed in two stages. The initial stage aimed to collect information about three physical capacities
previously linked to low-quality movement patterns
13–15
, in order to characterize the sample: hip posterolateral strength (Hip Stability
Isometric Test - HipSIT) using a hand held dynamometer (SPTech MedEOR Medtech®)
16
; close kinetic dorsiflexion range of motion
(ROM) using the iOS app Clinometer® (version 4.9.4)
17
; and side plank endurance time using a chronometer
18
.The normalized values of
HIPsit (Kgf) and absolute values of Dorsiflexion range of motion (degrees) was registered and classified as: 1 – below the reference
values; 2 – within the reference values; 3 – above the reference values. This classification followed the reference values stipulated for a
similar population
16,17
. Finally, the side plank endurance time identified those who have sufficient (≥60sec) or insufficient (<60sec) trunk
muscular resistance
18
.
The experimental protocol was conducted in a second meeting, at least 7 days apart. Initially, a 5-minute warm-up was
performed (running at preferred speed and ballistic stretching). The experimental protocol consisted of 2 series of 5 consecutive single-
leg jumps with the athlete's preferred leg on a force platform (Kistler model 9286B) at a sampling rate of 1000Hz, being the first serie
without trunk resistance (No-Resistance) and the second one with trunk resistance (With-Resistance). The jump height was not
controlled, the participants were instructed to perform consecutive vertical jumps as high as possible
19
, replicating possible training
series. The interval between sets was at least 30 seconds. To create multiplanar resistance of the trunk, a band was attached to the
ipsilateral shoulder of the volunteer's supporting leg, crossing the trunk posteriorly (Fig 1), and attached to a moderately tensioned elastic
tube (Elastos, color black) fixed to the floor.
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Brazilian Journal of Motor Behavior
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VOL.18
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“Manipulation of sensory information on postural control
performance of children, young and older adults”
Figure 1. Placement of the shoulder band used to generate the multiplanar trunk resistance.
Previously to the With-Resistance jump set, the elastic band was calibrated to impose an initial load equal to 6% of the athlete's
body mass. The magnitude of this load was chosen based on studies that showed improvement in muscle performance through post
activation potentiation
19
. Calibration was performed using a traction scale (Electronic Portable Scale, model 50Kg) tied to the elastic
band.
The analysis focused on the three intermediate jumps, excluding the first and last ones from the series. This approach aimed to
reduce the impact of transient factors associated with the beginning and the end of the series, such as initial adaptation and deceleration
in the last jump. Additionally, the sequence of jumps was standardized as No-Resistance followed by With-Resistance, as the previously
described phenomenon of post-activation potentiation could influence the execution of jumps without resistance performed after loaded
jumps and, consequently, could influence our results.
Force plate data were used to obtain the center of pressure position (COP) and the peak vertical force during the landing phase
(determined from a threshold of 20N). Data was smoothed (4th order Butterworth filter at a cut-off rate of 20 Hz), and six COP variables
were extracted: COP maximum displacement in the anteroposterior (COPap) and mediolateral directions (COPml); the dispersion of the
COP relative to its mean position, represented by the COP Root Mean Square in the anteroposterior (RMSap) and mediolateral
directions (RMSml); and COP mean velocity in the anteroposterior (Vap) and mediolateral (Vml) directions. Subsequently, the average
peak vertical force and COP variables across the three jumps were calculated for both No-Resistance and With-Resistance series.
Statistical Analyses
Since not all COP variables showed normal distribution (Shapiro-Wilk test) or variance homogeneity (Levene’s test), the
Wilcoxon test was used to compare No-Resistance and With-Resistance results. The results are presented as median and interquartile
range. To evaluate the trunk resistance effect on the peak vertical ground reaction force, the paired t-test was used. The effect size was
also calculated (d-Cohen) and a p value <0.05 was considered significant for all the analyses.
RESULTS
Considering the characterization of the participants, they presented the following quality movement’s scores: seventeen
participants (70.85%) scored 2 points, six participants (25%) scored 3 points, and one (4.15%) scored 4 points. Regarding the HipSIT
measurements, they showed an average of 0.42 Kgf/Kg (±0.09). The reference value for a similar population is 0.27 Kgf/Kg (±0.07).
Proportionally, participants exhibited the following distribution: eighteen (75%) participants above the reference value and six (25%)
within the reference value. As for the Range of Motion (ROM) measurements, participants had an average of 47° (±6.64). The reference
range for this measurement is 36°- 45°. Participants showed the following distribution: fourteen (58.33%) above the range, eight
(33.33%) within the range, and two (8.33%) below the range. Regarding trunk endurance, fifteen (62.5%) participants achieved 60
seconds.
All the COP variables showed a significant difference and a medium effect size (Table 1). There was a significant decrease of
the COPap (Z=-2.771, p=0.006), RMSap (Z=-2.600, p=0.009) and Vap (Z=-2.714, p=0.007), and an increase of the COPml (Z=-2.400,
p=0.016), RMSml (Z=-2.029, p=0.043) and Vml (Z=-2.029, p=0.043) during the jumps with trunk resistance.
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Table 1. Median and interquartile range (IQR) of the center of pressure (COP) variables considering jumps without (No-Resistance) and
with multiplanar trunk resistance (With-Resistance).
COP Variables
No-Resistance
With-Resistance
d
COPap (m)
0.063 (0.051-0.090)
0.055 (0.041-0.068)*
0.7
COPml (m)
0.022 (0.015-0.029)
0.029 (0.019-0.048)*
-0.5
RMSap (m)
0.019 (0.015-0.024)
0.016 (0.012-0.019)*
0.7
RMSml (m)
0.006 (0.004-0.008)
0.007 (0.005-0.013)*
-0.5
Vap (m/s)
0.774 (0.377-1.272)
0.708 (0.140-1.169)*
0.6
Vml (m/s)
0.222 (0.172-0.332)
0.305 (0.196-0.536)*
-0.5
COPap: anteroposterior displacement of the center of pressure. COPml: mediolateral displacement of the center of pressure. RMSap:
anteroposterior root mean square. RMSml: mediolateral root mean square. Vap: anteroposterior mean velocity. Vml: mediolateral mean
velocity. * Significantly different from No-Resistance at p < 0.05. d: effect size.
The mean peak vertical force during No-Resistance jumps was 1437N (±210), while With-Resistance jumps were 1470N
(±227). No significant difference was found (p = 0.457; d = -0.1555).
DISCUSSION
This study aimed to describe the influence of multiplanar trunk resistance on dynamic postural control during single-leg jumps
in female college athletes with poor movement quality. We observed a decrease in COP variables in the anteroposterior direction and an
increase in the mediolateral direction.
Our hypothesis suggesting that dynamic postural control would improve with the use of trunk resistance was partially
confirmed. A reduction in COP values in the anteroposterior direction was observed, while an increase occurred in the mediolateral
measures. Generally, the reduction in COP displacements, dispersion and velocities indicates an improvement in postural control.
Therefore, it could be said that dynamic postural control improved in the sagittal plane. However, when contextualizing these measures
with jumping tasks and considering that the main damping movements occur in the sagittal plane through trunk and lower limb joint
flexion, the reduction in these values may indicate smaller movements in this plane, such as shallow trunk flexion.
Landing with shallower trunk flexion angles tend to exhibit more rigid patterns and consequently higher vertical force values
8
.
However, there was no significant difference in the peak vertical force among our participants, which suggests that the decrease in the
anterior-posterior COP displacement and velocity is not related to a more rigid landing.
Regarding COP measures in the frontal plane, an increase during the use of the trunk resistance was observed. This result
indicates a worse dynamic postural control. Furthermore, an increase in mediolateral measures may indicate an increase in lateral trunk
flexion and, possibly, an increased load in the knee due to the medial-lateral displacement of the ground reaction force
8,20
. Hewett T et al.
21
observed that greater lateral inclinations of the trunk and abductor moment of the knee were associated with episodes of ACL injuries
in women. It has also been reported that athletes with a deficit in reaction time to sudden external forces on the trunk had a greater
number of ACL injuries, compared to those with more efficient trunk control responses
21,22
.
From a training perspective, to develop neuromuscular capacities, it is essential to employ challenging exercises. Nevertheless,
our results suggest that college athletes with poor movement quality should use the trunk multiplanar resistance with caution.
Considering the increase in the mediolateral displacement of the position of the ground reaction force (COP), the indiscriminate use of
this resistance could lead to overloads beyond the physiological limit of adaptation, predisposing to acute or overuse injuries. Since our
study did not measure knee forces, this hypothesis of risk of knee overload due to the increased body sway in the mediolateral direction
should be investigated in future studies. Nevertheless, taking into account the potential risks, while this issue is not clarified, less complex
exercises involving low speed movements should be used initially, such as single-leg squats. Besides, the influence of the magnitude of
the initial load imposed by the elastic tube should also be investigated.
The study has some limitations. We did not include a control group composed by college athletes with good movement quality.
Nonetheless, our objective was to describe the acute responses from the multiplanar trunk resistance in the population where this kind of
approach was indicated by the literature to better understand its potential training applications, instead of the adaptations induced by
training. Additionally, we did not test other load magnitudes, which must be investigated in future studies to better guide the prescription
of the multiplanar trunk resistance. The lack of randomization of the jump sequences may also be considered as a possible limitation.
However, based on the study of Halteman
19
, which described the post-activation potentiation effect in low-intensity external loaded
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jumps, we decided not to randomize, keeping the jumps without resistance first, since the pre-loaded jump could alter the execution of
subsequent vertical jumps without load. Lastly, due to a sample loss, we did not achieve the calculated sample size by 4 subjects.
CONCLUSION
Performing single-leg jumps with multiplanar trunk resistance may negatively impact dynamic postural control in female college
athletes with poor movement quality. Therefore, strategies for gradually increasing the complexity of training exercises using multiplanar
trunk resistance should be carefully considered in the prescription of workouts to improve postural control ability of athletes with poor
movement quality.
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2024
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https://doi.org/10.20338/bjmb.v18i1.385
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“Manipulation of sensory information on postural control
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Citation: de Menezes Cantusio LM, Ribeiro R, Misuta MS, Sarro KJ. (2024). How the multiplanar trunk resistance affects the dynamic postural control during single-leg
vertical jumps in college athletes with poor movement quality. Brazilian Journal of Motor Behavior, 18(1):1-6.
Editor-in-chief: Dr Fabio Augusto Barbieri - São Paulo State University (UNESP), Bauru, SP, Brazil.
Associate editors: Dr José Angelo Barela - São Paulo State University (UNESP), Rio Claro, SP, Brazil; Dr Natalia Madalena Rinaldi - Federal University of Espírito Santo
(UFES), Vitória, ES, Brazil; Dr Renato de Moraes – University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
Guest editors: Dr Paula Favaro Polastri Zago - São Paulo State University (UNESP), Bauru, SP, Brazil; Dr Daniela de Godoi Jacomassi – Federal University of São Carlos
(UFSCAR), São Carlos, SP, Brazil.
Copyright:© 2024 de Menezes Cantusio, Ribeiro and Misuta and BJMB. This is an open-access article distributed under the terms of the Creative Commons Attribution-
Non Commercial-No Derivatives 4.0 International License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and
source are credited.
Funding: Nothing to declare.
Competing interests: The authors have declared that no competing interests exist.
DOI: https://doi.org/10.20338/bjmb.v18i1.385