A Mini-Review on the Utilization of Force Plates in Athlete Rehabilitation

The force plate is an important evaluation device in athlete rehabilitation. This device measures the ground reaction forces generated by a body standing on or moving across it. It provides crucial kinetic and kinematic variables for evaluating athletic performance, tracking rehabilitation progress, and guiding treatment protocols [1-3]. Given the necessity to control the body and resultant forces during maneuvers in sports exercises, multi joint exercises using body weight and additional external loads are arguably the most common and essential type of resistance training for athletes. These exercises are critical for increasing strength, power, and for rehabilitating and preventing injuries. Therefore, it is imperative to quantify and compare the loads during such exercises to establish clear criteria for appropriate loading [4, 5]. The primary advantage of using a force plate in rehabilitation is its ability to provide objective, quantitative assessments. This allows sports scientists, athletic trainers, and physical therapists to accurately evaluate an athlete’s balance, stability, and gravity distribution [4,6,7]. By analyzing the data from the force plate, they can identify asymmetries or deficiencies in the athlete’s movement patterns, which can then be addressed through targeted rehabilitation exercises [8,9].

Additionally, most current studies utilize the force plate to evaluate an athlete’s lower limb strength and power. Such as vertical jumps, isometric maximum strength tests, and unilateral and bilateral squats performed on the force plate allow for the quantification of the athlete’s force, power generation, and rate of force development in the lower limbs [10-12]. This information is pivotal in developing personalized strength and conditioning programs aimed at enhancing athletic performance and mitigating injury risks [13- 15]. Beyond its diagnostic utility, the force plate also functions as a biofeedback mechanism during rehabilitation. By providing realtime visual or data feedback based on the athlete’s performance, it can enhance training by improving balance, coordination, and movement patterns [15,16]. This interactive feedback can increase the effectiveness of rehabilitation exercises and speed up the recovery process.

In summary, using the force plate to collect kinematic and kinetic parameters is a valuable tool in athlete training and rehabilitation. Its ability to provide objective measurements, evaluate lower limb strength and power, and deliver biofeedback underscores its critical role in optimizing athletic performance and ensuring a safe return to sports post-injury. As technology progresses, the significance of force plates in sports performance and rehabilitation will likely continue to grow.

Force plates are a valuable tool in athlete rehabilitation, providing crucial data and insights into an athlete’s movement patterns and biomechanics. By utilizing force plates, sports medicine professionals can better understand an athlete’s physical capabilities and limitations, ultimately leading to more effective rehabilitation strategies. This discussion will explore the kinematics and kinetic variables of force plates and their application in athlete rehabilitation.

Ground Reaction Forces (GRFs)

Sports injuries often occur during jumping, running, cutting, and Change of Direction (COD) tasks. These activities require athletes to decelerate by generating significant anterior and posterior Ground Reaction Forces (GRFs). After deceleration, they must redirect their center of mass, producing greater medial or lateral ground reaction forces. During jumping, athletes generate vertical force to propel upward and must stabilize and absorb impact upon landing [17- 19]. As speed and power increase, effectively modulating these multidirectional GRFs during jumping and cutting tasks is crucial for maintaining proper body support and positioning, thereby protecting against injury.

Rate of Force Development (RFD)

Rate of Force Development (RFD) determinants vary over time from force onset, with maximal strength playing a diminishing role as time decreases. Neural activation, fiber type composition, and muscle contractile properties significantly influence RFD, particularly in early rapid force development. Conventional moderate-load resistance training is often insufficient for restoring or enhancing RFD. Therefore, incorporating periodized resistance and explosive training techniques in late-stage rehabilitation is recommended before Returning to Sport (RTS)[20]. Lower limb Anterior Cruciate Ligament (ACL) injuries are common in athletes.

Full recovery after ACL reconstruction is often defined by achieving 85% to 90% of the contralateral limb’s maximal strength. However, since many daily and sports activities require quicker strength development than achieving maximal strength, neuromuscular functions like RFD should also be considered in the recovery criteria [1].

Asymmetry index

Analysis of GRF symmetry using force plate technology can indirectly assess knee kinetic symmetry. Understanding lower extremity asymmetry is crucial for evaluating injury risk, rehabilitation, and performance [6]. For example, individuals with anterior ACL reconstruction typically land with about 15% more force on their uninvolved limb during jump-landing tasks, and strength asymmetries greater than 15% are associated with higher injury risk [21-23]. This technology allows sports medicine professionals to objectively track patient progress throughout rehabilitation and provide athletes with feedback on their GRF symmetry during training.

Landing force

From a biomechanical perspective, landings require optimal technical performance and efficient absorption of impact forces to minimize injury risk. High-impact landing tasks are associated with various injuries, including ankle ligament sprains, patellar tendon injuries, and ACL ruptures. Previous studies have shown that measuring landing forces is crucial during an athlete’s rehabilitation [24]. For example, Cohen, Clarke [25] quantified Countermovement Jump (CMJ) peak force during take-off and landing in injured and healthy soccer players, finding that landing force asymmetries were 57% greater in injured players.

In conclusion, the force plate stands as a cornerstone in the realm of athlete rehabilitation and performance evaluation. Its role in providing objective data, guiding treatment plans, and enhancing athletic training is indispensable. As we look to the future, the continued evolution of force plate technology promises to further elevate its impact on sports performance and rehabilitation.

1. Angelozzi M, Marco Madama, Cristiana Corsica, Vittorio Calvisi, Gianfranco Properzi, et al. (2012) Rate of force development as an adjunctive outcome measure for return-to-sport decisions after anterior cruciate ligament reconstruction. Journal of Orthopaedic & Sports Physical Therapy 42(9): 772-780.
2. Veltink PH, Liedtke CB, Droog A, Kooij H (2005) Ambulatory measurement of ground reaction forces. IEEE Transactions on Neural Systems and Rehabilitation Engineering 13(3): 423-427.
3. Labban W, Thaer Manaseer, Eric Golberg, Mark Sommerfeldt, Stephanie Nathanail, et al. (2024) Jumping into recovery: A systematic review and meta‐analysis of discriminatory and responsive force plate parameters in individuals following anterior cruciate ligament reconstruction during countermovement and drop jumps. Journal of Experimental Orthopaedics 11(2): e12018.
4. Comfort P, Jones PA, Smith LC, Herrington L (2015) Joint kinetics and kinematics during common lower limb rehabilitation exercises. Journal of Athletic Training 50(10): 1011-1018.
5. Robles-Palazón FJ, Comfort P, Ripley NJ, Herrington L, Bramah C, et al. (2023) Force plate methodologies applied to injury profiling and rehabilitation in sport: A scoping review protocol. Plos one 18(10): e0292487.
6. Nelson A, Koslakiewicz N, Almonroeder TG (2018) Assessment of knee kinetic symmetry using force plate technology. Journal of Sport Rehabilitation 27(6): 609-611.
7. Quatman‐Yates CC, Hugentobler JA, Kurowski BG, Myer GD, Riley MA (2013) Test‐retest consistency of a postural sway assessment protocol for adolescent athletes measured with a force plate. International Journal of Sports Physical Therapy 8(6): 741-748.
8. Bishop C, Jason Lake, Irineu Loturco, Kostas Papadopoulos, Anthony Turner, et al. (2021) Interlimb asymmetries: The need for an individual approach to data analysis. Journal of Strength and Conditioning Research 35(3): 695-701.
9. Schmitt LC, Paterno MV, Ford KR, Myer GD, Hewett TE (2015) Strength asymmetry and landing mechanics at return to sport after ACL reconstruction. Medicine and Science in Sports and Exercise 47(7): 1426-1434.
10. Hernández-Davó JL, Sabido R (2014) Rate of force development: reliability, improvements and influence on performance. A review. European Journal of Human Movement 33: 46-69.
11. Beckham G, Suchomel T, Mizuguchi S (2014) Force plate use in performance monitoring and sport science testing. New Studies in Athletics 29(3): 25-37.
12. Loturco I, Pereira LA, Kobal R, Abad CCC, Victor Fernandes, et al. (2018) Portable force plates: A viable and practical alternative to rapidly and accurately monitor elite sprint performance. Sports 6(3): 61.
13. Rebelo A, Martinho DV, Valente-Dos-Santos J, Coelho-E-Silva MJ, Teixeira DS (2023) From data to action: A scoping review of wearable technologies and biomechanical assessments informing injury prevention strategies in sport. BMC Sports Science, Medicine and Rehabilitation15(1): 169.
14. Dufek JS, Bates BT (1991) Biomechanical factors associated with injury during landing in jump sports. Sports Medicine 12(5): 326-337.
15. Merrigan JJ, Stone JD, Martin JR, Hornsby WG, Galster SM, et al. (2021) Applying force plate technology to inform human performance programming in tactical populations. Applied Sciences 11(14): 6538.
16. Mullineaux DR, Underwood SM, Robert Shapiro, Hall JW (2012) Real-time biomechanical biofeedback effects on top-level rifle shooters. Applied Ergonomics 43(1): 109-114.
17. Baumgart C, Hoppe MW, Freiwald J (2017) Phase-specific ground reaction force analyses of bilateral and unilateral jumps in patients with ACL reconstruction. Orthopaedic Journal of Sports Medicine 5(6): 2325967117710912.
18. Lanier AS, Knarr BA, Stergiou N, Snyder-Mackler L, Buchanan TS (2020) ACL injury and reconstruction affect control of ground reaction forces produced during a novel task that simulates cutting movements. Journal of Orthopaedic Research 38(8): 1746-1752.
19. Dayakidis MK, Boudolos K (2006) Ground reaction force data in functional ankle instability during two cutting movements. Clinical Biomechanics 21(4): 405-411.
20. Buckthorpe M, Roi GS (2017) The time has come to incorporate a greater focus on rate of force development training in the sports injury rehabilitation process. Muscles, Ligaments and Tendons Journal 7(3): 435-441.
21. Paterno MV, Schmitt LC, Ford KR, Rauh MJ, Myer GD (2011) Effects of sex on compensatory landing strategies upon return to sport after anterior cruciate ligament reconstruction. Journal of Orthopaedic & Sports Physical Therapy 41(8): 553-559.
22. Impellizzeri FM, Ermanno Rampinini, Nicola Maffiuletti, Marcora SM (2007) A vertical jump force test for assessing bilateral strength asymmetry in athletes. Medicine and Science in Sports and Exercise 39(11): 2044-2050.
23. Bell DR, Sanfilippo JL, Binkley N, Heiderscheit BC (2014) Lean mass asymmetry influences force and power asymmetry during jumping in collegiate athletes. The Journal of Strength & Conditioning Research 28(4): 884-891.
24. Steele J, Sheppard J (2015) Landing mechanics in injury prevention and performance rehabilitation. 1^st (Edn.), Sports Injury Prevention and Rehabilitation, Routledge Publishers, UK, pp. 121-138.
25. Cohen D, Clarke N, Harland S, Lewin C (2014) Are force asymmetries measured in jump tests associated with previous injury in professional footballers? British Journal of Sports Medicine 48(7): 579-580.