scholarly journals Effect of Prophylactic Knee Bracing on Anterior Cruciate Ligament Agonist and Antagonist Muscle Forces During Perturbed Walking

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098164
Author(s):  
Raneem Haddara ◽  
Vahidreza Jafari Harandi ◽  
Peter Vee Sin Lee
Keyword(s):  
Anterior Cruciate Ligament ◽  
Stance Phase ◽  
Muscle Force ◽  
Cruciate Ligament ◽  
Patient Specific ◽  
Muscle Forces ◽  
Antagonist Muscle ◽  
Knee Mechanics ◽  
Agonist And Antagonist ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injuries most commonly occur after a perturbation. Prophylactic knee braces (PKBs) are off-the-shelf braces designed to prevent and reduce the severity of knee injuries during sports, yet their effectiveness has been debated. Purpose: To identify differences in ACL agonist and antagonist muscle forces, during braced and unbraced conditions, while walking with the application of unexpected perturbations. Study Design: Controlled laboratory study. Methods: A total of 20 recreational athletes were perturbed during walking at a speed of 1.1 m/s, and motion analysis data were used to create patient-specific musculoskeletal models. Static optimization was performed to calculate the lower-limb muscle forces. Statistical parametric mapping was used to compare muscle forces between the braced and unbraced conditions during the stance phase of the perturbed cycle. Results: The brace reduced muscle forces in the quadriceps (QUADS), gastrocnemius (GAS), and soleus (SOL) but not in the hamstrings. The peak QUADS muscle force was significantly lower with the brace versus without at 49% to 60% of the stance phase (28.9 ± 12.98 vs 14.8 ± 5.06 N/kg, respectively; P < .001) and again at 99% of the stance phase (1.7 ± 0.4 vs 3.6 ± 0.13 N/kg, respectively; P = .049). The SOL muscle force peak was significantly lower with the brace versus without at 25% of the stance phase (1.9 ± 1.7 vs 4.6 ± 3.4 N/kg, respectively; P = .031) and at 39% of the stance phase (1.9 ± 1.4 vs 5.3 ± 5.6 N/kg, respectively; P = .007). In the GAS, there were no significant differences between conditions throughout the whole stance phase except between 97% and 100%, where the braced condition portrayed a smaller peak force (0.23 ± 0.13 vs 1.4 ± 1.1 N/kg for unbraced condition; P = .024). Conclusion: These findings suggested that PKBs that restrict knee hyperextension and knee valgus/varus motion can alter neuromuscular patterns, which result in a reduction of QUADS force. Clinical Relevance: Understanding the way PKBs alter muscle function and knee mechanics can provide invaluable information that will help in making decisions about their use. Further studies should investigate different types of braces and perturbations to evaluate the effectiveness of PKBs.

Anterior Cruciate Ligament Reconstruction Affects Tibiofemoral Joint Congruency During Dynamic Functional Movement

2018 ◽  
Vol 46 (7) ◽  
pp. 1566-1574 ◽  
Author(s):  
Kanto Nagai ◽  
Tom Gale ◽  
James J. Irrgang ◽  
Scott Tashman ◽  
Freddie H. Fu ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Subchondral Bone ◽  
Contact Area ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Lateral Compartment ◽  
Patient Specific ◽  
Cruciate Ligament Reconstruction ◽  
Joint Congruency ◽  
Anterior Cruciate

Background: Anterior cruciate ligament reconstruction (ACLR) has been shown to alter kinematics, which may influence dynamic tibiofemoral joint congruency (a measure of how well the bone surfaces fit together). This may lead to abnormal loading of cartilage and joint degeneration. However, joint congruency after ACLR has never been investigated. Hypotheses: The ACLR knee will be more congruent than the contralateral uninjured knee, and dynamic congruency will increase over time after ACLR. Side-to-side differences (SSD) in dynamic congruency will be related to cartilage contact location/area and subchondral bone curvatures. Study Design: Descriptive laboratory study. Methods: The authors examined 43 patients who underwent unilateral ACLR. At 6 months and 24 months after ACLR, patients performed downhill running on a treadmill while synchronized biplane radiographs were acquired at 150 images per second. Dynamic tibiofemoral kinematic values were determined by use of a validated volumetric model-based tracking process that matched patient-specific bone models, obtained from computed tomography, to biplane radiographs. Patient-specific cartilage models, obtained from magnetic resonance imaging, were registered to tracked bone models and used to calculate dynamic cartilage contact regions. Principle curvatures of the subchondral bone surfaces under each cartilage contact area were calculated to determine joint congruency. Repeated-measures analysis of variance was used to test the differences. Multiple linear regression was used to identify associations between SSD in congruency index, cartilage contact area, contact location, and global curvatures of femoral or tibial subchondral bone. Results: Lateral compartment congruency in the ACLR knee was greater than in the contralateral knee ( P < .001 at 6 months and P = .010 at 24 months). From 6 to 24 months after surgery, dynamic congruency decreased in the medial compartment ( P = .002) and increased in the lateral compartment ( P = .007) in the ACLR knee. In the lateral compartment, SSD in joint congruency was related to contact location and femur global curvature, and in the medial compartment, SSD in joint congruency was related to contact area. Conclusion: ACLR appears to affect dynamic joint congruency. SSD in joint congruency was associated with changes in contact location, contact area, and femoral bony curvature. Clinical Relevance: Alterations in tibiofemoral contact location, contact area, and bone shape affect dynamic joint congruency, potentially contributing to long-term degeneration after ACLR.

scholarly journals Gait Biomechanics in Individuals Meeting Sufficient Quadriceps Strength Cutoffs Following Anterior Cruciate Ligament Reconstruction

2021 ◽  
Author(s):  
Brian Pietrosimone ◽  
Hope C. Davis-Wilson ◽  
Matthew K. Seeley ◽  
Christopher Johnston ◽  
Jeffrey T. Spang ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Stance Phase ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Quadriceps Strength ◽  
Cruciate Ligament Reconstruction ◽  
Gait Biomechanics ◽  
Anterior Cruciate

Abstract Context: Quadriceps weakness is associated with disability and aberrant gait biomechanics following anterior cruciate ligament reconstruction (ACLR). Strength sufficiency cutoff scores, that normalize quadriceps strength to the mass of an individual, are capable of predicting individuals who will report better function following ACLR. Yet, it remains unknown if gait biomechanics differ between individuals who meet a strength sufficiency cutoff (strong) compared to those who do not (weak). Objective: Determine if vertical ground reaction force (vGRF), knee flexion angle (KFA) and internal knee extension moment (KEM) differ between strong and weak individuals with an ACLR throughout stance phase of walking. Design: Comparison-control. Setting: Laboratory Participants: Individuals who received unilateral ACLR ≥12 months prior to testing were dichotomized into strong (n=31) and weak groups (n=116). Main Outcome Measures: Maximal isometric quadriceps strength was collected at 90° of knee flexion using an isokinetic dynamometer and normalized to body mass. Individuals demonstrating ≥3.0Nm/kg were considered strong. Three-dimensional gait biomechanics were collected at a self-selected walking speed. Biomechanical data were time-normalized to 100% of stance phase. vGRF were normalized to body weight (BW), and KEM was normalized to BW*height. Pairwise comparison functions were calculated for each outcome to identify between-group differences for each percentile of stance. Results: vGRF was significantly greater in weak participants for the first 22% of stance (average difference of 6.2% BW) and lesser in weak participants between 36–43% of stance (1.4% BW). KFA was significantly greater (i.e., more flexion) in strong participants between 6–62% of stance (2.3°) and lesser (i.e., less flexion) between 68-79% of stance (1.0°). KEM was significantly greater in strong participants between 7–62% of stance (0.007 BW*height). Conclusions: ACLR individuals able to generate knee extension torque ≥3.0Nm/kg exhibit different biomechanical gait profiles compared to weak individuals, which may allow for better energy attenuation following ACLR.

Evaluation of the Asymmetry of Leg Muscles Forces in the Subjects with Anterior Cruciate Ligament Reconstruction

2019 ◽  
Author(s):  
Keyvan Sharifmoradi ◽  
Mohammad Taghi Karimi ◽  
Yasin Hoseini
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Force ◽  
Cruciate Ligament ◽  
Force Production ◽  
Normal Subjects ◽  
Reduction In Force ◽  
Adductor Muscles ◽  
Hip Abductor ◽  
Anterior Cruciate ◽  
Analysis System

AbstractRunning asymmetry has not been assessed among patients with anterior cruciate ligament (ACL) deficiency. The aim of this study was to evaluate the spatiotemporal and muscle force asymmetry indexes in the subjects with ACL reconstruction (ACLR) compared with normal subjects. Eight individuals with a reconstructed ACL and eight individuals with intact ACLs were participated in this study. A Vicon motion analysis system and two Kistler force plates were used to record data. Muscle forces analysis was done by the use of OpenSim software. The results of this study showed that ACLR group had a significant weakness in hip abductor, extensor, and adductor muscles of the affected limb compared with healthy subjects (p < 0.05). In ACLR group, asymmetry of gluteus minimus muscle force was significantly greater than that of healthy group (p = 0.04). After the reconstruction of the ACL, there is still a significant asymmetry in muscle force as well as a reduction in force production of ACLR group especially in reconstructed side which put a person at high risk of reinjuries. Thus, strengthening of these muscles on the affected side to increase running performance of ACLR group is recommended.

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