Sports health · 2026
Sport-Specific Virtual Reality Tasks Reveal Distinct Patterns of Biomechanical Adaptation Compared With the Drop Vertical Jump.
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Hogg Jennifer A, Bonnette Scott, Riehm Christopher D, Thomas Staci, Anand Manish, DiCesare Christopher A, Barber Foss Kim D, Diekfuss Jed A, Beasley Katie, Schille Andrew, van der Haar Dustin, Grooms Dustin R, Simon Janet, Ulman Sophia, Danilkowicz Richard, Myer Gregory D, Riley Michael A
Аннотация
BACKGROUND: Neuromuscular training (NMT) improves biomechanical risk factors associated with anterior cruciate ligament (ACL) injury yet has failed to abate increasing ACL injury rates at scale. This study assessed sport-specific sensorimotor adaptations resulting from a NMT protocol with additive real-time sensorimotor augmented biofeedback (augmented NMT [aNMT] or sham aNMT) in a standardized drop vertical jump (DVJ) task and in ecologically valid sport-specific tasks performed in a simulated virtual reality (VR) environment.
HYPOTHESIS: Both training groups will display beneficial biomechanical changes in the standard DVJ, but aNMT will have greater transfer to the VR sport-specific scenario. Biomechanical improvements in DVJ will vary by sport, while improvements in VR sport-specific scenarios will not vary by sport.
STUDY DESIGN: Prospective longitudinal randomized placebo-controlled trial.
LEVEL OF EVIDENCE: Level 1.
METHODS: A total of 271 adolescent female soccer, basketball, and volleyball athletes performed 6 weeks of preseason NMT with additive aNMT or sham aNMT. Three-dimensional biomechanics were assessed at pre-/post-training that included DVJs and sport-specific VR tasks. Pre-/post-training standardized delta scores for both tasks were computed for hip and knee angles and external joint moments. Hierarchical clustering and chi-square analyses (omnibus and within each sport) assessed sport by intervention interactions for biomechanical transfer to both tasks.
RESULTS: Hierarchical clustering identified 3 DVJ clusters, 2 of which (N = 243) demonstrated beneficial pre-/post-training changes. A small proportion (10%) of athletes classified in a maladaptive cluster that consisted predominantly of aNMT participants, while sham aNMT made up a greater proportion of a beneficial adaptive cluster (χ2 = 6.06; P = 0.05). For the sport-specific VR task, 2 statistical clusters were identified, both characterized primarily by improved hip flexion angles regardless of sport.
CONCLUSION: Beneficial effects of aNMT and sham aNMT on the DVJ were observed in most participants, with aNMT accounting for a greater proportion of players exhibiting maladaptive DVJ changes. VR scenarios revealed consistently beneficial changes in landing biomechanics in all participants.
CLINICAL RELEVANCE: Sport-specific VR tasks may assess more nuanced levels of movement complexity than traditional laboratory-based tasks and provide a complementary approach to evaluate biomechanical adaptations resulting from NMT.
HYPOTHESIS: Both training groups will display beneficial biomechanical changes in the standard DVJ, but aNMT will have greater transfer to the VR sport-specific scenario. Biomechanical improvements in DVJ will vary by sport, while improvements in VR sport-specific scenarios will not vary by sport.
STUDY DESIGN: Prospective longitudinal randomized placebo-controlled trial.
LEVEL OF EVIDENCE: Level 1.
METHODS: A total of 271 adolescent female soccer, basketball, and volleyball athletes performed 6 weeks of preseason NMT with additive aNMT or sham aNMT. Three-dimensional biomechanics were assessed at pre-/post-training that included DVJs and sport-specific VR tasks. Pre-/post-training standardized delta scores for both tasks were computed for hip and knee angles and external joint moments. Hierarchical clustering and chi-square analyses (omnibus and within each sport) assessed sport by intervention interactions for biomechanical transfer to both tasks.
RESULTS: Hierarchical clustering identified 3 DVJ clusters, 2 of which (N = 243) demonstrated beneficial pre-/post-training changes. A small proportion (10%) of athletes classified in a maladaptive cluster that consisted predominantly of aNMT participants, while sham aNMT made up a greater proportion of a beneficial adaptive cluster (χ2 = 6.06; P = 0.05). For the sport-specific VR task, 2 statistical clusters were identified, both characterized primarily by improved hip flexion angles regardless of sport.
CONCLUSION: Beneficial effects of aNMT and sham aNMT on the DVJ were observed in most participants, with aNMT accounting for a greater proportion of players exhibiting maladaptive DVJ changes. VR scenarios revealed consistently beneficial changes in landing biomechanics in all participants.
CLINICAL RELEVANCE: Sport-specific VR tasks may assess more nuanced levels of movement complexity than traditional laboratory-based tasks and provide a complementary approach to evaluate biomechanical adaptations resulting from NMT.