Biomechanical effects of manipulating peak vertical ground reaction force throughout gait in individuals 6–12 months after anterior cruciate ligament reconstruction

Objectives To identify reported (1) common biomechanical asymmetries in the literature after anterior cruciate ligament (ACL) reconstruction in adolescents during landing and (2) timescales for asymmetry to persist postsurgery. Data Sources We identified sources by searching the CINAHL, PubMed, Scopus, and SPORTDiscus electronic databases using the following search terms: asymmetry OR symmetry AND landing AND biomechanics OR kinematics OR kinetics. Study Selection We screened the titles and abstracts of 85 articles using our inclusion criteria. A total of 13 articles were selected for further analysis. Data Extraction Three reviewers independently assessed the methodologic quality of each study. We extracted the effect sizes directly from studies or calculated them for biomechanical variables assessing asymmetry between limbs of participants with ACL reconstruction. We conducted meta-analyses on variables that were assessed in multiple studies for both double- and single-limb landings. Data Synthesis Asymmetry was more commonly identified in kinetic than kinematic variables. Anterior cruciate ligament reconstruction appeared to have a large effect on asymmetry between limbs for peak vertical ground reaction force, peak knee-extension moment, and loading rate during double-limb landings, as well as mean knee-extension moment and knee energy absorption during both double- and single-limb landings. Conclusions Our findings suggested that return-to-sport criteria after ACL reconstruction should incorporate analysis of the asymmetry in loading experienced by each limb rather than movement patterns alone.

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Greater peak vertical ground reaction force and vertical ground reaction force loading rate during walking gait are associated with a lower serum ratio of collagen turnover in individuals with anterior cruciate ligament reconstruction

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2015.02.825 ◽

2015 ◽

Vol 23 ◽

pp. A108-A109

Author(s):

B. Pietrosimone ◽

J.T. Blackburn ◽

M.S. Harkey ◽

B.A. Luc ◽

D.N. Pamukoff ◽

...

Keyword(s):

Ground Reaction Force ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Reaction Force ◽

Vertical Ground Reaction Force ◽

Lower Serum ◽

Walking Gait ◽

Vertical Ground ◽

Anterior Cruciate ◽

Serum Ratio

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Autoregressive Modeling as Diagnostic Tool to Identify Postanterior Cruciate Ligament Reconstruction Limb Asymmetry

Journal of Applied Biomechanics ◽

10.1123/jab.2018-0414 ◽

2019 ◽

Vol 35 (6) ◽

pp. 388-392 ◽

Cited By ~ 3

Author(s):

Kristin D. Morgan

Keyword(s):

Anterior Cruciate Ligament ◽

Dynamic Stability ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Reaction Force ◽

Return To Sport ◽

Vertical Ground Reaction Force ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate ◽

Limb Asymmetry

Between-limb deficits in vertical ground reaction force (vGRF) production continue to remain years after anterior cruciate ligament rehabilitation, resulting in altered dynamic stability. However, the challenge is in identifying ways to assess this between-limb stability. This study implemented second-order autoregressive [AR(2)] modeling and its stationarity triangle to both quantitatively and visually delineate differences in dynamic stability from peak vGRF data in controls and post-anterior cruciate ligament reconstruction (ACLR) individuals during running. It was hypothesized that post-ACLR individuals would exhibit less dynamic stability than the controls, and that they would reside in a different location on the stationarity triangle, thus denoting differences in stability. The results presented supported the hypothesis that post-ACLR individuals exhibited significantly less dynamic stability than their control counterparts based on their model coefficients (AR1 P < .01; AR2 P = .02). These findings suggested that the post-ACLR individuals adopted a similar running pattern, possibly due to muscle weakness asymmetry, which was less dynamically stable and potentially places them at greater risk for injury. The ability of this approach to both quantitatively and visually delineate differences between these 2 groups indicates its potential as a return-to-sport decision tool.

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Longitudinal Kinetic and Kinematic Changes in Functional Tasks After Reconstructing Anterior Cruciate Ligament: A Systematic Review

Journal of Exercise Science and Medicine ◽

10.32598/jesm.12.1.2 ◽

2020 ◽

Vol 12 (1) ◽

pp. 133-146

Author(s):

Fatemeh Sharafoddin-Shirazi ◽

◽

Amir Letafatkar ◽

Zohreh Gholami ◽

◽

...

Keyword(s):

Systematic Review ◽

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Reaction Force ◽

Return To Sports ◽

Cruciate Ligament Reconstruction ◽

Peak Knee ◽

Anterior Cruciate

Introduction: The return to sport after Anterior Cruciate Ligament Reconstruction (ACLR) is among the main issues encountered by rehabilitation medicine, injured athletes, and coaches. A main factor preventing safe return to sports is a biomechanical asymmetry between the limbs during reconstruction, which plays a significant role in the risk of re-injury. Accordingly, injury-related biomechanical changes were systematically examined in individuals with ACLR as performed functional tasks. Materials and Methods: Articles relevant to biomechanical asymmetries between (ACLR & uninjured) limbs in English were searched in the Google Scholar, Science Direct, PubMed MEDLINE, and Scopus databases without time limit until 2021, using the following keywords: “Anterior cruciate ligament reconstruction”, “ACL reconstruction”, “biomechanical”, “Kinetic”, “Kinematic”, and “Asymmetry”. Results: In total, 122 articles were found, of which 18 met the inclusion (PRISMA) criteria. Most of the kinetic and kinematic parameters were observed in the intervals of 3, 6, 9, 12, and 18 months after ACLR between the athletes’ vertical Ground Reaction Force (vGRF), peak hip abduction moment, peak knee valgus angle, peak knee flexion moment and angle, during the functional tasks; also changes were detected in the articles up to 28 months, although research in this area was limited. Conclusion: The present systematic review suggested that biomechanical variables may vary among the limbs of patients with ACLR, between 18 and over 28 months. Accordingly, an asymmetry between the limbs increases the risk of re-injury. Therefore, a better understanding of the biomechanics of the limbs in the time intervals after ACLR can provide a safer and sooner return to sports activities.

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