Single-leg postural stability deficits following anterior cruciate ligament reconstruction in pediatric and adolescent athletes

2016 ◽  
Vol 25 (4) ◽  
pp. 338-342 ◽  
Author(s):  
Dai Sugimoto ◽  
David R. Howell ◽  
Lyle J. Micheli ◽  
William P. Meehan
Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 639
Author(s):  
Eva M. Ciccodicola ◽  
Nicole M. Mueske ◽  
Mia J. Katzel ◽  
Curtis D. VandenBerg ◽  
James Lee Pace ◽  
...  

This study investigated asymmetry between lower extremities during the landing and takeoff phases of a vertical drop jump (VDJ) in adolescent athletes following anterior cruciate ligament reconstruction (ACLR) and examined if performance was affected by reducing jump height. Thirty-three athletes who underwent ACLR and were referred for 3D biomechanical assessment before returning to play (mean age 15.9, SD 1.3 years; 16/33 female; mean time since surgery 7.4, SD 1.2 months) completed the VDJ while kinematics and kinetics were collected using motion capture. Lower extremity symmetry was compared between phases using paired t-tests. Jump height was calculated to measure performance. Asymmetries in ankle inversion, ankle adduction, knee adduction, hip adduction, hip adduction moment, and hip rotation moment were observed in both phases. Asymmetry was also observed in both phases for sagittal moments and power integrals at the knee and ankle and total power integral, with the magnitude of asymmetry being smaller during takeoff for power absorption/generation. Jump height was related to power generation integrals during takeoff but not to the asymmetry of power generation. Since asymmetries are translated from landing through takeoff, rehabilitation should address both phases to decrease injury risk and maximize performance after return to play.


2021 ◽  
Vol 15 ◽  
Author(s):  
Tim Lehmann ◽  
Daniel Büchel ◽  
Caroline Mouton ◽  
Alli Gokeler ◽  
Romain Seil ◽  
...  

Whereas initial findings have already identified cortical patterns accompanying proprioceptive deficiencies in patients after anterior cruciate ligament reconstruction (ACLR), little is known about compensatory sensorimotor mechanisms for re-establishing postural control. Therefore, the aim of the present study was to explore leg dependent patterns of cortical contributions to postural control in patients 6 weeks following ACLR. A total of 12 patients after ACLR (25.1 ± 3.2 years, 178.1 ± 9.7 cm, 77.5 ± 14.4 kg) and another 12 gender, age, and activity matched healthy controls participated in this study. All subjects performed 10 × 30 s. single leg stances on each leg, equipped with 64-channel mobile electroencephalography (EEG). Postural stability was quantified by area of sway and sway velocity. Estimations of the weighted phase lag index were conducted as a cortical measure of functional connectivity. The findings showed significant group × leg interactions for increased functional connectivity in the anterior cruciate ligament (ACL) injured leg, predominantly including fronto−parietal [F(1, 22) = 8.41, p ≤ 0.008, η2 = 0.28], fronto−occipital [F(1, 22) = 4.43, p ≤ 0.047, η2 = 0.17], parieto−motor [F(1, 22) = 10.30, p ≤ 0.004, η2 = 0.32], occipito−motor [F(1, 22) = 5.21, p ≤ 0.032, η2 = 0.19], and occipito−parietal [F(1, 22) = 4.60, p ≤ 0.043, η2 = 0.17] intra−hemispherical connections in the contralateral hemisphere and occipito−motor [F(1, 22) = 7.33, p ≤ 0.013, η2 = 0.25] on the ipsilateral hemisphere to the injured leg. Higher functional connectivity in patients after ACLR, attained by increased emphasis of functional connections incorporating the somatosensory and visual areas, may serve as a compensatory mechanism to control postural stability of the injured leg in the early phase of rehabilitation. These preliminary results may help to develop new neurophysiological assessments for detecting functional deficiencies after ACLR in the future.


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