scholarly journals Association between Kinesiophobia and Gait Asymmetry after ACL Reconstruction: Implications for Prevention of Reinjury

2021 ◽  
Vol 18 (6) ◽  
pp. 3264
Author(s):  
Hossein Tajdini ◽  
Amir Letafatkar ◽  
Britton W. Brewer ◽  
Mahdi Hosseinzadeh
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Muscular Activity ◽  
Vertical Ground Reaction Force ◽  
Contact Phase ◽  
Significant Positive Association ◽  
Gait Symmetry ◽  
Gait Asymmetry ◽  
The Relationship

Gait asymmetries have been documented in individuals after anterior cruciate ligament (ACL) reconstruction (ACLR). The relationship between gait asymmetry and associated psychological factors, however, is not yet known. This study aimed to examine the relationship between kinesiophobia (fear of reinjury) and asymmetry of vertical ground reaction force (vGRF) and lower-extremity muscular activity in individuals after ACLR during gait. Twenty-eight males with a history of ACLR participated in the study. Force plate and surface electromyography was used to record peak vGRF and muscular activity. The Tampa Scale of Kinesiophobia (TSK-11) was used to measure kinesiophobia. Spearman’s rank correlations analysis was used to examine the relationship between TSK-11 scores and both gait asymmetry variables. There was a significant positive relationship between TSK-11 and asymmetry of the second peak of vGRF (rs = 0.531, p = 0.002). In addition, there was a significant positive association between asymmetry of rectus femoris activity (rs = 0.460, p = 0.007) and biceps femoris activity (rs = 0.429, p = 0.011) in the contact phase. Results revealed a significant relationship between kinesiophobia and asymmetry in muscle activity and vGRF in different phases of the gait cycle. Interventions addressing kinesiophobia early in the rehabilitation after ACLR may support the restoration of gait symmetry, facilitate a more rapid return to sport, and reduce the risk of ACL reinjury.

scholarly journals Between-Limb Symmetry during Double-Leg Vertical Hop Landing in Males an Average of Two Years after ACL Reconstruction is Highly Correlated with Postoperative Physiotherapy Supervision Duration

2018 ◽  
Vol 8 (12) ◽  
pp. 2586
Author(s):  
Aleksandra Królikowska ◽  
Andrzej Czamara ◽  
Paweł Reichert
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Positive Association ◽  
The Body ◽  
Vertical Ground Reaction Force ◽  
Vertical Ground ◽  
Anterior Cruciate ◽  
Highly Correlated ◽  
Tendon Autograft

This study investigates whether double-leg and single-leg vertical hops (VH) landing between-limb symmetry in males, an average of two years after anterior cruciate ligament (ACL) reconstruction (ACLR), is associated with postoperative physiotherapy supervision duration. Thirty-eight healthy controls and thirty-eight males after primary unilateral ACLR, with the use of ipsilateral semitendinosus and gracilis tendon autograft, on average two years before, underwent bilateral peak vertical ground reaction force (vGRF) measurements during double-leg and single-leg VH landing, using two force plates. The vGRF was normalized to the body mass (vGRF BM). The vGRF BM limb symmetry index (LSI) was calculated. Tests for dependent and independent samples and linear Pearson’s correlation coefficient (r) calculations were performed. There were significant between-leg differences in the double-leg (p < 0.001) vGRF BM values. The longer the postoperative physiotherapy supervision duration was, the higher the double-leg VH LSI values (r = 0.727; p < 0.001). There was also a significant but weak positive association between the single-leg VH landing LSI value and the physiotherapy supervision duration (r = 0.333; p = 0.041). Between-limb symmetry during double-leg VH landing in males, an average of two years after ACLR, was correlated with postoperative physiotherapy supervision duration. Fully supervised postoperative physiotherapy for a minimum of six months is more effective for improving VH landing limb symmetry in patients after ACLR.

scholarly journals Relationship between Asymmetry of Gait and Muscle Torque in Patients after Unilateral Transfemoral Amputation

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Alicja Rutkowska-Kucharska ◽  
Mateusz Kowal ◽  
Sławomir Winiarski
Keyword(s):  
Hip Joint ◽  
Reaction Force ◽  
Transfemoral Amputation ◽  
Gait Symmetry ◽  
Symmetry Index ◽  
Muscle Torque ◽  
Effective Form ◽  
Gait Asymmetry ◽  
Torque Values ◽  
Therapy Programme

Many studies have shown that unilateral transfemoral amputation involves asymmetric gait. Transfemoral amputation leads to muscle atrophy in a tight stump resulting in asymmetry in muscle torque between the amputated and intact limb. This research is aimed at verifying if a relationship between torque values of hip joint flexors and extensors and gait asymmetry in patients with TFA exists. Fourteen adult subjects with unilateral TFA took part in the experiment. Gait symmetry was evaluated based on the ground reaction force (GRF). Measurements of muscle torque of hip flexors and extensors were taken with a Biodex System. All measurements were taken under isokinetic (60°/s and 120°/s) and isometric conditions. The symmetry index of vertical GRF components was from 7.5 to 11.5%, and anterio-posterior GRF from 6.2 to 9.3%. The symmetry index for muscle torque was from 24.3 to 44% for flexors, from 39 to 50.5% for extensors, and from 28.6 to 50% in the flexor/extensor ratio. Gait asymmetry correlated with muscle torque in hip joint extensors. Therapy which enhances muscle torque may be an effective form of patient therapy. The patient needs to undergo evaluation of their muscle strength and have the therapy programme adjusted to their level of muscle torque deficit.

scholarly journals The Relationship Between Vertical Loadrates and Tibial Acceleration Across Footstrike Patterns

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0020 ◽  
Author(s):  
Irene Davis ◽  
Todd Hayano ◽  
Adam Tenforde
Keyword(s):  
Impact Loading ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
Force Plate ◽  
Correlation Coefficients ◽  
Strongly Correlated ◽  
Vertical Ground Reaction Force ◽  
Vertical Ground ◽  
Tibial Acceleration ◽  
The Relationship

Category: Other Introduction/Purpose: While the etiology of injuries is multifactorial, impact loading, as measured by the loadrate of the vertical ground reaction force has been implicated. These loadrates are typically measured with a force plate. However, this limits the measure of impacts to laboratory environments. Tibial acceleration, another measure of running impacts, is considered a surrogate for loadrate. It can be measured using new wearable technology that can be used in a runner’s natural environment. However, the correlation between tibial acceleration measured from mobile devices and vertical ground reaction force loadrates, measured from forceplates, is unknown. The purpose of this study was to determine the correlation between vertical and resultant loadrates to vertical and resultant tibial acceleration across different footstrike patterns (FSP) in runners. Methods: The study involved a sample of convenience made up of 169 runners (74 F, 95 M; age: 38.66±13.08 yrs) presenting at a running injury clinic. This included 25 habitual forefoot strike (FFS), 17 midfoot strike (MFS) and 127 rearfoot strike (RFS) runners. Participants ran on an instrumented treadmill (average speed 2.52±0.25 m/s), with a tri-axial accelerometer attached at the left distal medial tibia. Only subjects running with pain <3/10 on a VAS scale during the treadmill run were included to reduce the confounding effect of pain. Vertical average, vertical instantaneous and resultant instantaneous loadrates (VALR, VILR and RILR) and peak vertical and resultant tibial accelerations (VTA, RTA) were averaged for 8 consecutive left steps. Correlation coefficients (r) were calculated between tibial accelerations and loadrates. Results: All tibial accelerations were significantly correlated across all loadrates, with the exception of RTA with VILR for FFS (Table 1) which was nearly significant (p=0.068). Correlations ranged from 0.37-0.82. VTA was strongly correlated with all loadrates (r = 0.66). RTA was also strongly correlated with both loadrates for RFS and MFS, but only moderately correlated with loadrates for FFS (r = 0.47). Correlations were similar across the different loadrates (VALR, VILR, RILR). Conclusion: The stronger correlation between vertical tibial acceleration and all loadrates (VALR, VILR, RILR) suggests that it may be the best surrogate for loadrates when studying impact loading in runners.

Lower Leg Girth and Ankle Plantar-Flexor Endurance after Anterior Cruciate Ligament Reconstruction

2002 ◽  
Vol 11 (2) ◽  
pp. 128-138 ◽  
Author(s):  
Michael D. Ross ◽  
Shelly Hooten ◽  
Darren Moore
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Plantar Flexion ◽  
Lower Leg ◽  
Plantar Flexor ◽  
Rehabilitation Programs ◽  
Anterior Cruciate ◽  
The Relationship

Objective:To determine the relationship between asymmetries in lower leg girth and standing heel-rise after anterior cruciate ligament (ACL) reconstruction.Design:Single-group posttest.Participants:15 at a mean of 30 d after ACL reconstruction.Measurements:Lower leg girth and number of repetitions performed on the standing heel-rise test.Results:A significant decrease in lower leg girth and number of repetitions performed on the standing heel-rise test for the involved leg. There was also a low correlation between asymmetries in lower leg girth and standing heel-rise test (r= .25).Conclusion:Ankle plantar-flexor endurance should be considered when developing rehabilitation programs for the early stages after ACL reconstruction. In this study the ankle of the involved leg attained a significantly smaller angle of maximal standing plantar flexion, suggesting that ankle range of motion should also be assessed. Caution should be used in predicting standing heel-rise asymmetries from asymmetries in lower leg girth in ACL-reconstructed patients.

scholarly journals Anterior Cruciate Ligament Rupture and Osteoarthritis Progression

2012 ◽  
Vol 6 (1) ◽  
pp. 295-300 ◽  
Author(s):  
James Min-Leong Wong ◽  
Tanvir Khan ◽  
Chethan S Jayadev ◽  
Wasim Khan ◽  
David Johnstone
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Degenerative Change ◽  
Acl Rupture ◽  
Osteoarthritis Progression ◽  
Anterior Cruciate ◽  
The Relationship ◽  
Meniscal Damage ◽  
Acl Deficient

Anterior Cruciate Ligament (ACL) rupture is a common sporting injury that frequently affects young, athletic patients. Apart from the functional problems of instability, patients with ACL deficient knees also develop osteoarthritis. Although this is frequently cited as an indication for ACL reconstruction, the relationship between ACL rupture, reconstruction and the instigation and progression of articular cartilage degenerative change is controversial. The purpose of this paper is to review the published literature with regards ACL rupture and the multifactorial causes for osteoarthritis progression, and whether or not this is slowed or stopped by ACL reconstruction. There is no evidence in the published literature to support the view that ACL reconstruction prevents osteoarthritis, although it may prevent further meniscal damage. It must be recognised that this conclusion is based on the current literature which has substantial methodological limitations.

The Relationship Between Vertical Ground Reaction Force, Loading Rate, and Sound Characteristics During a Single-Leg Landing

2020 ◽  
Vol 29 (5) ◽  
pp. 541-546
Author(s):  
Caroline Lisee ◽  
Tom Birchmeier ◽  
Arthur Yan ◽  
Brent Geers ◽  
Kaitlin O’Hagan ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Loading Rate ◽  
Reaction Force ◽  
Measurement Techniques ◽  
Sound Frequency ◽  
Clinical Population ◽  
Vertical Ground Reaction Force ◽  
Vertical Ground ◽  
The Relationship ◽  
Linear Loading

Context: Landing kinetic outcomes are associated with injury risk and may be persistently altered after anterior cruciate ligament injury or reconstruction. However, it is challenging to assess kinetics clinically. The relationship between sound characteristics and kinetics during a limited number of functional tasks has been supported as a potential clinical alternative. Objective: To assess the relationship between kinetics and sound characteristics during a single-leg landing task. Design: Observational Setting: Laboratory. Participants: There was total of 26 healthy participants (15 males/11 females, age = 24.8 [3.6] y, height = 176.0 [9.1] cm, mass = 74.9 [14.4] kg, Tegner Activity Scale = 6.1 [1.1]). Intervention: Participants completed single-leg landings onto a force plate while audio characteristics were recorded. Main Outcome Measures: Peak vertical ground reaction force, linear loading rate, instantaneous loading rate, peak sound magnitude, sound frequency were measured. Means and SDs were calculated for each participant’s individual limbs. Spearman rho correlations were used to assess the relationships between audio characteristics and kinetic outcomes. Results: Peak sound magnitude was positively correlated with normalized peak vertical ground reaction force (ρ = .486, P = .001); linear loading rate (ρ = .491, P = .001); and instantaneous loading rate (ρ = .298, P = .03). Sound frequency was negatively correlated with instantaneous loading rate (ρ = −.444, P = .001). Conclusions: Peak sound magnitude may be more helpful in providing feedback about an individual’s normalized vertical ground reaction force and linear loading rate, and sound frequency may be more helpful in providing feedback about instantaneous loading rate. Further refinement in sound measurement techniques may be required before these findings can be applied in a clinical population.

Change in Drop-Landing Mechanics Over 2 Years in Young Athletes After Anterior Cruciate Ligament Reconstruction

2019 ◽  
Vol 47 (11) ◽  
pp. 2608-2616 ◽  
Author(s):  
Matthew P. Ithurburn ◽  
Mark V. Paterno ◽  
Staci Thomas ◽  
Michael L. Pennell ◽  
Kevin D. Evans ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Knee Extension ◽  
Trunk Flexion ◽  
Young Athletes ◽  
Vertical Ground Reaction Force ◽  
Drop Landing ◽  
Vertical Ground ◽  
Anterior Cruciate

Background: While between-limb landing asymmetries after anterior cruciate ligament reconstruction (ACLR) are linked with poor function and risk of additional injury, it is not currently understood how landing symmetry changes over time after ACLR. Purpose/Hypothesis: The purpose was to investigate how double-legged drop vertical jump (DVJ) landing and single-legged drop-landing symmetry changed from the time of return-to-sport (RTS) clearance to 2 years later in a prospective cohort of young athletes after ACLR. It was hypothesized that double-legged DVJ landing and single-legged drop-landing symmetry would improve from the time of RTS to 2 years later. Study Design: Descriptive laboratory study. Methods: The authors followed 64 young athletes with primary, unilateral ACLR for 2 years after RTS clearance. At the time of RTS and 2 years later, between-limb symmetry values for biomechanical variables of interest (VOIs) were calculated with 3-dimensional motion analysis during double-legged DVJ and single-legged drop-landing tasks. VOIs included knee flexion excursion, peak internal knee extension moment, peak vertical ground-reaction force, and peak trunk flexion (for single-legged task only). Symmetry values and proportions of participants meeting 90% symmetry cutoffs were compared between time points. Results: For double-legged DVJ landing, symmetry values for all VOIs and the proportions meeting 90% cutoffs for peak internal knee extension moment and peak vertical ground-reaction force were higher at 2 years after RTS as compared with RTS. For single-legged drop-landing, symmetry values were higher for knee flexion excursion and lower for peak trunk flexion at 2 years after RTS as compared with RTS, but the proportions meeting 90% cutoffs for all VOIs did not differ between time points. Conclusion: Double-legged DVJ landing symmetry improved across VOIs over the 2 years after RTS following ACLR, while single-legged drop-landing did not improve as consistently. The implications of longitudinal landing asymmetry after ACLR should be further studied.

scholarly journals Biomechanics of Lower Limbs during Walking among Candidates for Total Knee Arthroplasty with and without Low Back Pain

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
David R. Burnett ◽  
Naira H. Campbell-Kyureghyan ◽  
Robert V. Topp ◽  
Peter M. Quesada
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Reaction Force ◽  
Lower Limbs ◽  
Low Back ◽  
Vertical Ground Reaction Force ◽  
Gait Patterns ◽  
Gait Symmetry ◽  
Group I ◽  
Group Ii

The effect of joint pathologies, such as unilateral knee osteoarthritis (UKOA) or low back pain (LBP), on bilateral gait symmetry has gained increased attention during the past decade. This study is the first to compare gait patterns between patients with UKOA and LBP in combination and with UKOA only. Temporal, kinematic, and kinetic variables were measured bilaterally during gait stance phase in 31 subjects with UKOA and LBP (Group I) and 11 subjects with only UKOA (Group II). Group I patients exhibited less hip rotation in the affected limb (A) than in the nonaffected (NA) limb during walking in contrast to Group II patients. Group I patients had minimal bilateral differences in hip abduction and flexion, but Group II patients displayed significantly larger values in the NA limb compared to the A limb for both parameters. Hip flexion patterns were significantly different between Groups I and II. Subjects in both groups adapted gait patterns that minimized vertical ground reaction force, knee flexion motion, and stance time on the UKOA affected limb. The distinct kinematic gait patterns that were revealed in this study may provide clinical value for assessment of patients with UKOA in conjunction with LBP.

scholarly journals Jump-Landing Biomechanics and Knee-Laxity Change Across the Menstrual Cycle in Women With Anterior Cruciate Ligament Reconstruction

2014 ◽  
Vol 49 (2) ◽  
pp. 154-162 ◽  
Author(s):  
David R. Bell ◽  
J. Troy Blackburn ◽  
Anthony C. Hackney ◽  
Stephen W. Marshall ◽  
Anthony I. Beutler ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Knee Laxity ◽  
Acl Injury ◽  
Initial Contact ◽  
Vertical Ground Reaction Force ◽  
Jump Landing ◽  
Anterior Knee Laxity ◽  
Anterior Cruciate

Context: Of the individuals able to return to sport participation after an anterior cruciate ligament(ACL) injury, up to 25% will experience a second ACL injury. This population may be more sensitive to hormonal fluctuations, which may explain this high rate of second injury. Objective: To examine changes in 3-dimensional hip and knee kinematics and kinetics during a jump landing and to examine knee laxity across the menstrual cycle in women with histories of unilateral noncontact ACL injury. Design  Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: A total of 20 women (age = 19.6 ± 1.3 years, height = 168.6 ± 5.3 cm, mass = 66.2 ± 9.1 kg) with unilateral, noncontact ACL injuries. Intervention(s) Participants completed a jump-landing task and knee-laxity assessment 3 to 5 days after the onset of menses and within 3 days of a positive ovulation test. Main Outcome Measure(s): Kinematics in the uninjured limb at initial contact with the ground during a jump landing, peak kinematics and kinetics during the loading phase of landing, anterior knee laxity via the KT-1000, peak vertical ground reaction force, and blood hormone concentrations (estradiol-β-17, progesterone, free testosterone). Results: At ovulation, estradiol-β-17 (t = −2.9, P = .009), progesterone (t = −3.4, P = .003), and anterior knee laxity (t = −2.3, P = .03) increased, and participants presented with greater knee-valgus moment (Z = −2.6, P = .01) and femoral internal rotation (t = −2.1, P = .047). However, during the menses test session, participants landed harder (greater peak vertical ground reaction force; t = 2.2, P = .04), with the tibia internally rotated at initial contact (t = 2.8, P = .01) and greater hip internal-rotation moment (Z = −2.4, P = .02). No other changes were observed across the menstrual cycle. Conclusions Knee and hip mechanics in both phases of the menstrual cycle represented a greater potential risk of ACL loading. Observed changes in landing mechanics may explain why the risk of second ACL injury is elevated in this population.

scholarly journals Lower Limb Asymmetry After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 55 (8) ◽  
pp. 811-825 ◽  
Author(s):  
Gerwyn Hughes ◽  
Perry Musco ◽  
Samuel Caine ◽  
Lauren Howe
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Knee Extension ◽  
Cruciate Ligament Reconstruction ◽  
Peak Knee ◽  
Anterior Cruciate

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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