The BodiTrak Pressure Mat: Data-Driven Progression for Return to Sport & Performance by Sasha Kolbeck, MPT, DPT, OCS, COMT
injury risk patterns, increase performance and later evaluate return to sport through data and achieving goals established by research. Progressing through exercise and movements may give quantity; however, is it quality movement? Exercise alone does not let us know if the athlete is continuing to compensate. Evidence shows that landing mechanics from a jump may indicate injury risk. At RoseCity Physical Therapywe have incorporated the BodiTrak pressure mat for clinical decision making to guide progression for the lower and upper extremity athlete and for discharge criteria to increase performance and decrease future injury. Research supports that just putting in physical therapy work as an athlete is not enough. We need measurements that provide data; that which is not visible without sensors and technology. Some recommended metrics are Rate of Force Development (RFD), Dynamic Vertical Force (DVF), Ground Reaction Force (GRF), Reactive Strength Index (RSI), and Reactive Strength Index Modified (RSI Mod). • RFD is how quickly you can generate force • DVF is relative to the force of a person’s body weight • GRF is the magnitude of force generated on a surface • RSI is the strength and power ability which couples concentric and eccentric movements in the stretch- shorten-cycles in variations of vertical jump • RSI Modified is calculated from a countermovement jump These metrics give a detailed objective picture of the athlete’s current athletic function and performance. A squat can look symmetric, but data will give a different more true picture. An athlete can compensate and offload or alter loading on the surgical leg. This asymmetry can continue with single-leg squat, hop, jump, and running - unless discovered and corrected. And if not corrected, compensations can lead to re-injury, breakdown, and decreased performance. We can measure jump distance or height without BodiTrak, but we would not know if the athlete has a slower RFD, which research is finding is linked to the athlete’s perception of outcome. Anecdotally, I see the data match up with the psychological confidence of jumping, landing, and cutting.
Reinjury rates after ACL reconstruction are 20% for those that return to sport, 23% for those under age 25 who return to sport, and 5% for professional athletes who meet discharge criteria and return to sport. If ACL revision surgery is required due to re-injury, there is a 30% failure rate and additional physical therapy is also necessary. In light of these statistics, we need to have criteria to determine the most appropriate time to return to sport to minimize re-injury rates. We know that a postoperative timeline is not the best determination for return to sport. Research shows waiting 9 to 12 months, and over 12 months for those under age 20, decreases re-injury risk after ACL reconstruction. Grindem has shown that re-injury is further decreased to 3.5 to 5%by waiting 9 months to return to sport and by passing testing criteria. Experts report testing needs to be comprehensive using a battery of tests, as compensation can hide deficits during functional movement. Using only the opposite leg for comparison can also deceive decisions of when to return to sport, as research shows the contralateral limb has a decline in strength and power during the recovery process. Myself and my colleague, Leo Quinn, PT have seen it time and again when testing our post-op ACL patients who can relatively quickly match their opposite limb measurements, but they are still not functional. The BodiTrak pressure mat is one tool that provides helpful objective metrics during physical therapy treatment to assess and cue movements such as squatting and jumping through the use of video, biofeedback, and metrics to decrease
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