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Johansson, G. M. & Häger, C. K. (2019). A modified standardized nine hole peg test for valid and reliable kinematic assessment of dexterity post-stroke. Journal of NeuroEngineering and Rehabilitation, 16(1), Article ID 8.
Open this publication in new window or tab >>A modified standardized nine hole peg test for valid and reliable kinematic assessment of dexterity post-stroke
2019 (English)In: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 16, no 1, article id 8Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Impairments in dexterity after stroke are commonly assessed by the Nine Hole Peg Test (NHPT), where the only outcome variable is the time taken to complete the test. We aimed to kinematically quantify and to compare the motor performance of the NHPT in persons post-stroke and controls (discriminant validity), to compare kinematics to clinical assessments of upper extremity function (convergent validity), and to establish the within-session reliability.

METHODS: The NHPT was modified and standardized (S-NHPT) by 1) replacing the original peg container with an additional identical nine hole pegboard, 2) adding a specific order of which peg to pick, and 3) specifying to insert the peg taken from the original pegboard into the corresponding hole of the target pegboard. Eight optical cameras registered upper body kinematics of 30 persons post-stroke and 41 controls during the S-NHPT. Four sequential phases of the task were identified and analyzed for kinematic group differences. Clinical assessments were performed.

RESULTS: The stroke group performed the S-NHPT slower (total movement time; mean diff 9.8 s, SE diff 1.4), less smoothly (number of movement units; mean diff 0.4, SE diff 0.1) and less efficiently (path ratio; mean diff 0.05, SE diff 0.02), and used increased scapular/trunk movements (acromion displacement; mean diff 15.7 mm, SE diff 3.5) than controls (P < 0.000, r ≥ 0.32), indicating discriminant validity. The stroke group also spent a significantly longer time grasping and releasing pegs relative to the transfer phases of the task compared to controls. Within the stroke group, kinematics correlated with time to complete the S-NHPT and the Fugl-Meyer Assessment (rs 0.38-0.70), suggesting convergent validity. Within-session reliability for the S-NHPT was generally high to very high for both groups (ICCs 0.71-0.94).

CONCLUSIONS: The S-NHPT shows adequate discriminant validity, convergent validity and within-session reliability. Standardization of the test facilitates kinematic analysis of movement performance, which in turn enables identification of differences in movement control between persons post-stroke and controls that may otherwise not be captured through the traditional time-based NHPT. Future research should ascertain further psychometric properties, e.g. sensitivity, of the S-NHPT.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Clinical laboratory techniques, Outcome assessment, Stroke, Upper extremity
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-155494 (URN)10.1186/s12984-019-0479-y (DOI)000455641600001 ()30642350 (PubMedID)
Funder
Västerbotten County CouncilThe Swedish Brain Foundation
Available from: 2019-01-18 Created: 2019-01-18 Last updated: 2019-02-08Bibliographically approved
Grip, H., Nilsson, K. G., Häger, C. G., Lundström, R. & Öhberg, F. (2019). Does the Femoral Head Size in Hip Arthroplasty Influence Lower Body Movements during Squats, Gait and Stair Walking?: A Clinical Pilot Study Based on Wearable Motion Sensors. Sensors, 19(14), Article ID 3240.
Open this publication in new window or tab >>Does the Femoral Head Size in Hip Arthroplasty Influence Lower Body Movements during Squats, Gait and Stair Walking?: A Clinical Pilot Study Based on Wearable Motion Sensors
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2019 (English)In: Sensors, ISSN 1424-8220, E-ISSN 1424-8220, Vol. 19, no 14, article id 3240Article in journal (Refereed) Published
Abstract [en]

A hip prosthesis design with larger femoral head size may improve functional outcomes compared to the conventional total hip arthroplasty (THA) design. Our aim was to compare the range of motion (RoM) in lower body joints during squats, gait and stair walking using a wearable movement analysis system based on inertial measurement units (IMUs) in three age-matched male groups: 6 males with a conventional THA (THAC), 9 with a large femoral head (LFH) design, and 8 hip- and knee-asymptomatic controls (CTRL). We hypothesized that the LFH design would allow a greater hip RoM, providing movement patterns more like CTRL, and a larger side difference in hip RoM in THAC when compared to LFH and controls. IMUs were attached to the pelvis, thighs and shanks during five trials of squats, gait, and stair ascending/descending performed at self-selected speed. THAC and LFH participants completed the Hip dysfunction and Osteoarthritis Outcome Score (HOOS). The results showed a larger hip RoM during squats in LFH compared to THAC. Side differences in LFH and THAC groups (operated vs. non-operated side) indicated that movement function was not fully recovered in either group, further corroborated by non-maximal mean HOOS scores (LFH: 83 +/- 13, THAC: 84 +/- 19 groups, vs. normal function 100). The IMU system may have the potential to enhance clinical movement evaluations as an adjunct to clinical scales.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
MEMS, gyroscopes, accelerometers, total hip arthroplasty, movement analysis
National Category
Orthopaedics Physiotherapy
Identifiers
urn:nbn:se:umu:diva-162882 (URN)10.3390/s19143240 (DOI)000479160300207 ()31340548 (PubMedID)
Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-10-07Bibliographically approved
Markström, J., Grip, H., Schelin, L. & Häger, C. K. (2019). Dynamic knee control and movement strategies in athletes and non‐athletes in side hops: implications for knee injury. Scandinavian Journal of Medicine and Science in Sports, 29(8), 1181-1189
Open this publication in new window or tab >>Dynamic knee control and movement strategies in athletes and non‐athletes in side hops: implications for knee injury
2019 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 29, no 8, p. 1181-1189Article in journal (Refereed) Published
Abstract [en]

Athletes exposed to rapid maneuvers need a high level of dynamic knee stability and robustness, while also controlling whole body movement, to decrease the risk of non‐contact knee injury. The effects of high‐level athletic training on such measures of movement control have not, however, been thoroughly evaluated. This study investigated whether elite athletes (who regularly perform knee‐specific neuromuscular training) show greater dynamic knee robustness and/or different movement strategies than non‐athletic controls, in relation to overall knee function. Thirty‐nine women (19 athletes, 20 controls) performed standardized rebound side hops (SRSH) while a motion capture system synchronized with two force plates registered three‐dimensional trunk, hip, and knee joint angles and moments. Dynamic knee robustness was evaluated using finite helical axis (FHA) inclination angles extracted from knee rotation intervals of 10°, analyzed with independent t tests. Angle and moment curves were analyzed with inferential methods for functional data. Athletes had superior knee function (less laxity, greater hop performances, and strength) but presented similar FHA inclination angles to controls. Movement strategies during the landing phase differed; athletes presented larger (a) hip flexion angles (during 9%‐29% of the phase), (b) hip adduction moments (59%‐99%), (c) hip internal rotation moments (83%‐89%), and (d) knee flexion moments (79%‐93%). Thus, elite athletes may have a greater ability than non‐athletes to keep the knee robust while performing SRSH more efficiently through increased engagement of the hip. However, dynamic knee robustness associated with lower FHA inclination angles still show room for improvement, thus possibly decreasing knee injury risk.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
biomechanics, injury prevention, kinematics, kinetics, sports
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-159135 (URN)10.1111/sms.13432 (DOI)000475431400013 ()30972848 (PubMedID)2-s2.0-85068897729 (Scopus ID)
Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-08-12Bibliographically approved
Suijkerbuijk, M. A. M., Ponzetti, M., Rahim, M., Posthumus, M., Häger, C., Stattin, E., . . . September, A. V. (2019). Functional polymorphisms within the inflammatory pathway regulate expression of extracellular matrix components in a genetic risk dependent model for anterior cruciate ligament injuries.. Journal of Science and Medicine in Sport, 22(11), 1219-1225
Open this publication in new window or tab >>Functional polymorphisms within the inflammatory pathway regulate expression of extracellular matrix components in a genetic risk dependent model for anterior cruciate ligament injuries.
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2019 (English)In: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, Vol. 22, no 11, p. 1219-1225Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate the functional effect of genetic polymorphisms of the inflammatory pathway on structural extracellular matrix components (ECM) and the susceptibility to an anterior cruciate ligament (ACL) injury.

DESIGN: Laboratory study, case-control study.

METHODS: Eight healthy participants were genotyped for interleukin (IL)1B rs16944 C>T and IL6 rs1800795 G>C and classified into genetic risk profile groups. Differences in type I collagen (COL1A1), type V collagen (COL5A1), biglycan (BGN) and decorin (DCN) gene expression were measured in fibroblasts either unstimulated or following IL-1β, IL-6 or tumor necrosis factor (TNF)-α treatment. Moreover, a genetic association study was conducted in: (i) a Swedish cohort comprised of 116 asymptomatic controls (CON) and 79 ACL ruptures and (ii) a South African cohort of 100 CONs and 98 ACLs. Participants were genotyped for COL5A1 rs12722 C>T, IL1B rs16944 C>T, IL6 rs1800795 G>C and IL6R rs2228145 G>C.

RESULTS: IL1B high-risk fibroblasts had decreased BGN (p=0.020) and COL5A1 (p=0.012) levels after IL-1β stimulation and expressed less COL5A1 (p=0.042) following TNF-α treatment. Similarly, unstimulated IL6 high-risk fibroblasts had lower COL5A1 (p=0.012) levels than IL6 low-risk fibroblasts. In the genetic association study, the COL5A1-IL1B-IL6 T-C-G (p=0.034, Haplo-score 2.1) and the COL5A1-IL1B-IL6R T-C-A (p=0.044, Haplo-score: 2.0) combinations were associated with an increased susceptibility to ACL injury in the Swedish cohort when only male participants were evaluated.

CONCLUSIONS: This study shows that polymorphisms within genes of the inflammatory pathway modulate the expression of structural and fibril-associated ECM components in a genetic risk depended manner, contributing to an increased susceptibility to ACL injuries.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Anterior cruciate ligament injury, Extracellular matrix, Genetics, Personalized medicine, Polymorphisms
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-163874 (URN)10.1016/j.jsams.2019.07.012 (DOI)31395468 (PubMedID)2-s2.0-85072364464 (Scopus ID)
Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2019-10-08Bibliographically approved
Arumugam, A., Markström, J. L. & Häger, C. K. (2019). Introducing a novel test with unanticipated medial/lateral diagonal hops that reliably captures hip and knee kinematics in healthy women. Journal of Biomechanics, 82, 70-79
Open this publication in new window or tab >>Introducing a novel test with unanticipated medial/lateral diagonal hops that reliably captures hip and knee kinematics in healthy women
2019 (English)In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 82, p. 70-79Article in journal (Refereed) Published
Abstract [en]

Despite a vast literature on one-leg hops and cutting maneuvers assessing knee control pre/post-injury of the anterior cruciate ligament (ACL), comprehensive and reliable tests performed under unpredictable conditions are lacking. This study aimed to: (1) assess the feasibility of an innovative, knee-challenging, one-leg double-hop test consisting of a forward hop followed by a diagonal hop (45°) performed medially (UMDH) or laterally (ULDH) in an unanticipated manner; and (2) determine within- and between-session reliability for 3-dimensional hip and knee kinematics and kinetics of these tests. Twenty-two healthy women (22.3 ± 3.3 years) performed three successful UMDH and ULDH, twice 1–4 weeks apart. Hop success rate was 69–84%. Peak hip and knee angles demonstrated moderate to excellent within-session reliability (intraclass correlation coefficient [ICC] 95% confidence interval [CI]: 0.67–0.99, standard error of measurement [SEM] ≤  3°) and poor to excellent between-session reliability (ICC CI: 0.22–0.94, SEM ≤ 3°) for UMDH and ULDH. The smallest real difference (SRD) was low (≤ 5°) for nearly all peak angles. Peak hip and knee moments demonstrated poor to excellent reliability (ICC CI: 0–0.97) and, in general, moments were more reliable within-session (SEM ≤ 0.14 N.m/kg.m, both directions) than between-session (SRD ≤ 0.43 N.m/kg.m). Our novel test was feasible and, in most but not all cases, provided reliable angle estimates (within-session > between-session, both directions) albeit less reliable moments (within-session > between-session, both directions). The relatively large hip and knee movements in the frontal and transverse planes during the unanticipated hops suggest substantial challenge of dynamic knee control. Thus, the test seems appropriate for evaluating knee function during ACL injury rehabilitation.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Motion analysis, Biomechanics, Anterior cruciate ligament, Sports, Rehabilitation
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-152959 (URN)10.1016/j.jbiomech.2018.10.015 (DOI)000456353700008 ()30392773 (PubMedID)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-02-26Bibliographically approved
Österlund, C., Nilsson, E., Hellström, F., Häger, C. & Häggman-Henrikson, B. (2019). Jaw-neck movement integration in 6-year-old children differs from that of adults. Journal of Oral Rehabilitation
Open this publication in new window or tab >>Jaw-neck movement integration in 6-year-old children differs from that of adults
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2019 (English)In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children.

OBJECTIVES: To determine the movement integration between the jaw and neck during jaw motor tasks in 6-year-olds, whether there is a difference between children and adults.

METHODS: Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6-year-olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening-closing and self-paced gum chewing. Jaw and neck movement amplitudes, intra-individual variation in movement amplitude, ratio between neck-jaw movement amplitudes and movement cycle time were analysed. Differences between children and adults were evaluated with Mann-Whitney U test for independent samples.

RESULTS: Compared to adults, 6-year-old children showed larger neck movement amplitudes (P = .008) during chewing, higher intra-individual variability in amplitudes of jaw (P = .008) and neck (P = .001) movements, higher ratio between neck-jaw movement amplitudes for jaw opening-closing (P = .026) and chewing (P = .003), and longer jaw movement cycle time (P ≤ .0001) during the jaw opening-closing task.

CONCLUSION: Despite integrated jaw-neck movements in 6-year-old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw-neck motor behaviour. The well-integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well-controlled longitudinal studies to map this development in order to provide appropriate age-related clinical treatment for functional disorders.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
adult, child, head, jaw, motor activity, movements
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-163875 (URN)10.1111/joor.12865 (DOI)000483252900001 ()31357241 (PubMedID)2-s2.0-85070938798 (Scopus ID)
Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2019-10-21
Arumugam, A., Strong, A., Tengman, E., Röijezon, U. & Häger, C. (2019). Psychometric properties of knee proprioception tests targeting healthy individuals and those with anterior cruciate ligament injury managed with or without reconstruction: a systematic review protocol. BMJ Open, 9(4), Article ID e027241.
Open this publication in new window or tab >>Psychometric properties of knee proprioception tests targeting healthy individuals and those with anterior cruciate ligament injury managed with or without reconstruction: a systematic review protocol
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e027241Article, review/survey (Refereed) Published
Abstract [en]

Introduction: An anterior cruciate ligament (ACL) injury affects knee proprioception and sensorimotor control and might contribute to an increased risk of a second ACL injury and secondary knee osteoarthritis. Therefore, there is a growing need for valid, reliable and responsive knee proprioception tests. No previous study has comprehensively reviewed all the relevant psychometric properties (PMPs) of these tests together. The aim of this review protocol is to narrate the steps involved in synthesising the evidence for the PMPs of specific knee proprioception tests among individuals with an ACL injury and knee-healthy controls.

Methods and analysis: The Preferred Reporting Items for Systematic reviews and Meta-Analyses will be followed to report the review. A combination of four conceptual groups of terms-(1) construct (knee proprioception), (2) target population (healthy individuals and those with an ACL injury managed conservatively or with a surgical reconstruction), (3) measurement instrument (specific knee proprioception tests) and (4) PMPs (reliability, validity and responsiveness)-will be used for electronic databases search. PubMed, AMED, CINAHL, SPORTDiscus, Web of Science, Scopus, the Cochrane Central Register of Controlled Trials and ProQuest will be searched from their inception to November 2018. Two reviewers will independently screen titles, abstracts and full text articles, extract data and perform risk of bias assessment using the updated COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist for the eligible studies. A narrative synthesis of the findings and a meta-analysis will be attempted as appropriate. Each PMP of knee proprioception tests will be classified as 'sufficient', 'indeterminate' or 'insufficient'. The overall level of evidence will be ascertained using an established set of criteria.

Ethics and dissemination: Ethical approval or patient consent is not required for a systematic review. The review findings will be submitted as a series of manuscripts for peer-review and publication in scientific journals.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-161462 (URN)10.1136/bmjopen-2018-027241 (DOI)000471157200233 ()30948613 (PubMedID)
Funder
Swedish Research Council, K2014-99X-21876-04-4Västerbotten County Council, VLL548501
Available from: 2019-07-09 Created: 2019-07-09 Last updated: 2019-07-09Bibliographically approved
Markström, J. L., Schelin, L. & Häger, C. K. (2018). A novel standardised side hop test reliably evaluates landing mechanics for anterior cruciate ligament reconstructed persons and controls. Sports Biomechanics
Open this publication in new window or tab >>A novel standardised side hop test reliably evaluates landing mechanics for anterior cruciate ligament reconstructed persons and controls
2018 (English)In: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116Article in journal (Refereed) Epub ahead of print
Abstract [en]

We propose a novel one-leg standardised rebound side-hop test (SRSH) specifically designed for detailed analysis of landing mechanics. Anterior cruciate ligament reconstructed persons (ACLR, n = 30) and healthy-knee controls (CTRL, n = 30) were tested for within-session and test-retest (CTRL only, n = 25) reliability and agreement. Trunk, hip and knee angles and moments in sagittal, frontal, and transversal planes during landing, including time to stabilisation (TTS), were evaluated using intra-class correlations (ICCs), average within-person standard deviations (SW) and minimal differences. Excellent within-session reliability were found for angles in both groups (most ICCs > 0.90, SW ≤ 5°), and excellent to good for moments (most ICCs > 0.80, SW ≤ 0.34 Nm/kg). Only knee internal rotation moment showed poor reliability (ICC < 0.4). Test-retest results were excellent to fair for all angles and moments (ICCs 0.47–0.91, SW < 5° and ≤ 0.25 Nm/kg), except for peak trunk lateral bending angle and knee internal rotation moment. TTS showed excellent to fair within-session reliability but poor test-retest results. These results, with a few exceptions, suggest promising potential of evaluating landing mechanics during the SRSH for ACLR and CTRL, and emphasise the importance of joint-specific movement control variables in standardised tasks.

Place, publisher, year, edition, pages
Routledge, 2018
Keywords
reliability, agreement, sports, kinematics, kinetics
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-152960 (URN)10.1080/14763141.2018.153835 (DOI)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-05-20
Markström, J. L., Tengman, E. & Häger, C. (2018). ACL-reconstructed and ACL-deficient individuals show differentiated trunk, hip, and knee kinematics during vertical hops more than 20 years post-injury. Knee Surgery, Sports Traumatology, Arthroscopy, 26(2), 358-367
Open this publication in new window or tab >>ACL-reconstructed and ACL-deficient individuals show differentiated trunk, hip, and knee kinematics during vertical hops more than 20 years post-injury
2018 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 26, no 2, p. 358-367Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Little is known regarding movement strategies in the long term following injury of the anterior cruciate ligament (ACL), and even less about comparisons of reconstructed and deficient knees in relation to healthy controls. The present purpose was to compare trunk, hip, and knee kinematics during a one-leg vertical hop (VH) ~20 years post-ACL injury between persons treated with surgery and physiotherapy (ACLR), solely physiotherapy (ACLPT), and controls (CTRL). Between-leg kinematic differences within groups were also investigated.

METHODS: Sixty-six persons who suffered unilateral ACL injury on average 23 ± 2 years ago (32 ACLR, 34 ACLPT) and 33 controls performed the VH. Peak trunk, hip, and knee angles during Take-off and Landing phases recorded with a 3D motion capture system were analysed with multivariate statistics.

RESULTS: Significant group effects during both Take-off and Landing were found, with ACLPT differing from CTRL in Take-off with a combination of less knee flexion and knee internal rotation, and from both ACLR and CTRL in Landing with less hip and knee flexion, knee internal rotation, and greater hip adduction. ACLR also presented different kinematics to ACLPT and CTRL in Take-off with a combination of greater trunk flexion, hip flexion, hip internal rotation, and less knee abduction, and in Landing with greater trunk flexion and hip internal rotation. Further, different kinematics and hop height were found between legs within groups in both Take-off and Landing for both ACL groups, but not for CTRL.

CONCLUSION: Different kinematics for the injured leg for both ACL groups compared to CTRL and between treatment groups, as well as between legs within treatment groups, indicate long-term consequences of injury. Compensatory mechanisms for knee protection seem to prevail over time irrespective of initial treatment, possibly increasing the risk of re-injury and triggering the development of osteoarthritis. Detailed investigation of movement strategies during the VH provides important information and a more comprehensive evaluation of knee function than merely hop height. More attention should also be given to the trunk and hip in clinics when evaluating movement strategies after ACL injury.

LEVEL OF EVIDENCE: Prospective cohort study, Level II.

Keywords
Anterior cruciate ligament, Long-term, Movement strategy, One-leg vertical hop, Treatment
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-144713 (URN)10.1007/s00167-017-4528-4 (DOI)000424056400002 ()28337590 (PubMedID)
Available from: 2018-02-12 Created: 2018-02-12 Last updated: 2019-05-20Bibliographically approved
Hébert-Losier, K., Schelin, L., Tengman, E., Strong, A. & Häger, C. (2018). Curve analyses reveal altered knee, hip, and trunk kinematics during drop-jumps long after anterior cruciate ligament rupture. Knee (Oxford), 25(2), 226-239
Open this publication in new window or tab >>Curve analyses reveal altered knee, hip, and trunk kinematics during drop-jumps long after anterior cruciate ligament rupture
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2018 (English)In: Knee (Oxford), ISSN 0968-0160, E-ISSN 1873-5800, Vol. 25, no 2, p. 226-239Article in journal (Refereed) Published
Abstract [en]

Background: Anterior cruciate ligament (ACL) ruptures may lead to knee dysfunctions later in life. Single-leg tasks are often evaluated, but bilateral movements may also be compromised. Our aim was to use curve analyses to examine double-leg drop–jump kinematics in ACL-reconstructed, ACL-deficient, and healthy-knee cohorts.

Methods: Subjects with unilateral ACL ruptures treated more than two decades ago (17–28 years) conservatively with physiotherapy (ACLPT, n = 26) or in combination with reconstructive surgery (ACLR, n = 28) and healthy-knee controls (n = 25) performed 40-cm drop–jumps. Three-dimensional knee, hip, and trunk kinematics were analyzed during Rebound, Flight, and Landing phases. Curves were time-normalized and compared between groups (injured and non-injured legs of ACLPT and ACLR vs. non-dominant and dominant legs of controls) and within groups (between legs) using functional analysis of variance methods.

Results: Compared to controls, ACL groups exhibited less knee and hip flexion on both legs during Rebound and greater knee external rotation on their injured leg at the start of Rebound and Landing. ACLR also showed less trunk flexion during Rebound. Between-leg differences were observed in ACLR only, with the injured leg more internally rotated at the hip. Overall, kinematic curves were similar between ACLR and ACLPT. However, compared to controls, deviations spanned a greater proportion of the drop–jump movement at the hip in ACLR and at the knee in ACLPT.

Conclusions: Trunk and bilateral leg kinematics during double-leg drop–jumps are still compromised long after ACL-rupture care, independent of treatment. Curve analyses indicate the presence of distinct compensatory mechanisms in ACLPT and ACLR compared to controls.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
ACL, Biomechanics, Functional data analysis, Interval testing procedure, Lower extremity, Rehabilitation
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-145719 (URN)10.1016/j.knee.2017.12.005 (DOI)000430519800004 ()29525548 (PubMedID)2-s2.0-85042919592 (Scopus ID)
Available from: 2018-03-15 Created: 2018-03-15 Last updated: 2018-09-19Bibliographically approved
Projects
Knee function after ACL injury - a long term follow up with focus on detailed movement analysis, osteoarthritis and quality of life. [2010-03622_VR]; Umeå UniversityKnee Function after ACL Injury - genetic predisposition, clinical and laboratory assessment and long term consequences in relation to treatment, development of ostheoarthritis and quality of life. [2013-02802_VR]; Umeå UniversityKnee Motor Control after Injury of the Anterior Cruciate Ligament: Clinical and Laboratory-Based Assessment in relation to Functional Performance, Proprioception and Associated Brain Activity [2017-00892_VR]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0366-4609

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