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Atypical lower limb mechanics during weight acceptance of stair descent at different time frames after anterior cruciate ligament reconstruction
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. (U-Motion Laboratory)ORCID iD: 0000-0002-6339-9544
Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.ORCID iD: 0000-0001-7917-5687
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.ORCID iD: 0000-0002-0366-4609
2022 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 50, no 8, p. 2125-2133Article in journal (Refereed) Published
Abstract [en]

Background: An anterior cruciate ligament (ACL) rupture may result in poor sensorimotor knee control and, consequentially, adapted movement strategies to help maintain knee stability. Whether patients display atypical lower limb mechanics during weight acceptance of stair descent at different time frames after ACL reconstruction (ACLR) is unknown.

Purpose:To compare the presence of atypical lower limb mechanics during the weight acceptance phase of stair descent among athletes at early, middle, and late time frames after unilateral ACLR.

Study Design:Controlled laboratory study.

Methods:A total of 49 athletes with ACLR were classified into 3 groups according to time after ACLR—early (<6 months; n = 17), middle (6-18 months; n = 16), and late (>18 months; n = 16)—and compared with asymptomatic athletes (control; n = 18). Sagittal plane hip, knee, and ankle angles; angular velocities; moments; and powers were compared between the ACLR groups’ injured and noninjured legs and the control group as well as between legs within groups using functional data analysis methods.

Results:All 3 ACLR groups showed greater knee flexion angles and moments than the control group for injured and noninjured legs. For the other outcomes, the early group had, compared with the control group, less hip power absorption, more knee power absorption, lower ankle plantarflexion angle, lower ankle dorsiflexion moment, and less ankle power absorption for the injured leg and more knee power absorption and higher vertical ground reaction force for the noninjured leg. In addition, the late group showed differences from the control group for the injured leg revealing more knee power absorption and lower ankle plantarflexion angle. Only the early group took a longer time than the control group to complete weight acceptance and demonstrated asymmetry for multiple outcomes.

Conclusion:Athletes with different time frames after ACLR revealed atypically large knee angles and moments during weight acceptance of stair descent for both the injured and the noninjured legs. These findings may express a chronically adapted strategy to increase knee control. In contrast, atypical hip and ankle mechanics seem restricted to an early time frame after ACLR.

Clinical Relevance:Rehabilitation after ACLR should include early training in controlling weight acceptance. Including a control group is essential when evaluating movement patterns after ACLR because both legs may be affected.

Place, publisher, year, edition, pages
Sage Publications, 2022. Vol. 50, no 8, p. 2125-2133
Keywords [en]
ACL, stepping down, motion analysis, biomechanics, functional data analysis
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-194427DOI: 10.1177/03635465221095236PubMedID: 35604127Scopus ID: 2-s2.0-85131002442OAI: oai:DiVA.org:umu-194427DiVA, id: diva2:1656181
Funder
Swedish Research Council, 2016-02763Swedish Research Council, K2014-99X-21876-04-4Swedish Research Council, 2017-00892Region Västerbotten, ALF VLL548501Region Västerbotten, VLL838421Region Västerbotten, VLL358901Swedish National Centre for Research in Sports, IH 5.3- 13-2017Konung Gustaf V:s och Drottning Victorias FrimurarestiftelseAvailable from: 2022-05-04 Created: 2022-05-04 Last updated: 2024-01-10Bibliographically approved

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Markström, JonasLiebermann, Dario G.Schelin, LinaHäger, Charlotte

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