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Background: Proper lower extremity biomechanics during bilateral landing is important for reducing injury risk in athletes returning to sports after anterior cruciate ligament reconstruction (ACLR). Although landing is a quick ballistic movement that is difficult to modify, squatting is a slower cyclic movement that is ideal for motor learning. Hypothesis: There is a relationship between lower extremity biomechanics during bilateral landing and bilateral squatting in patients with an ACLR. Study Design: Descriptive laboratory study. Methods: A total of 41 patients after a unilateral ACLR (24 men, 17 women; 5.9 ± 1.4 months after ACLR) completed 15 unweighted bilateral squats and 10 bilateral stop-jumps. Three-dimensional lower extremity kinematics and kinetics were collected, and peak knee abduction angle, knee abduction/adduction range of motion, peak vertical ground-reaction force limb symmetry index (LSI), vertical ground-reaction force impulse LSI, and peak knee extension moment LSI were computed during the descending phase of the squatting and landing tasks. Wilcoxon signed-rank tests were used to compare each outcome between limbs, and Spearman correlations were used to compare outcomes between the squatting and landing tasks. Results: The peak vertical ground reaction force, the vertical ground reaction force impulse, and the peak knee extension moment were reduced in the surgical (Sx) limb relative to the nonsurgical (NSx) limb during both the squatting and landing tasks ( P < .001). The relationship between squatting and landing tasks was strong for the peak knee abduction angle ( R = 0.697-0.737; P < .001); moderate for the frontal plane knee range of motion (NSx: R = 0.366, P = .019; Sx: R = 0.418, P = 0.007), the peak knee extension moment LSI ( R = 0.573; P < .001), the vertical ground reaction force impulse LSI ( R = 0.382; P < .014); and weak for the peak vertical ground reaction force LSI ( R = 0.323; P = .039). Conclusion: Patients who have undergone an ACLR continue to offload their surgical limb during both squatting and landing. Additionally, there is a relationship between movement deficits during squatting and movement deficits during landing in patients with an ACLR preparing to return to sports. Clinical Relevance: As movement deficits during squatting and landing were related before return to sports, this study suggests that interventional approaches to improve squatting biomechanics may translate to improved landing biomechanics in patients with an ACLR.

Objective: To evaluate if the measurement of gait parameters performed in the course of an ankle-foot orthosis (AFO) fitting has a beneficial effect on the gait pattern of people affected by an acute stroke. Design: Before-after trial. Setting: Stroke orthotic clinic of a freestanding rehabilitation hospital. Participants: 8 people with hemiparesis secondary to acute stroke who were able to ambulate safely without an orthosis. Interventions: The subjects were required to walk without and then with a newly designed AFO over a 4.57m-long and 0.9m-wide GaitRite mat. The system recorded the temporospatial characteristics of gait on a portable computer. In both conditions, each subject performed three 10-m walks, with rest periods between trials. Main Outcome Measures: Velocity, cadence, and step length. Results: The mean velocity without and with an AFO was 34.84Ϯ11.11 and 46.86Ϯ12.83cm/s, respectively (F 1,7 ϭ10.95, PϽ.01); the mean cadence without and with an AFO was 53.78Ϯ8.85 and 63.01Ϯ9.24 steps/min, respectively (F 1,7 ϭ24.65, PϽ.01); the mean step length on the affected side without and with an AFO was 38.83Ϯ4.72 and 43.11Ϯ4.76cm, respectively, and the main step length on the nonaffected side was 29.31Ϯ5.98 and 36.05Ϯ6.62cm (F 1,7 ϭ6.04, PϽ.05). Conclusions: Results indicate that AFO utilization significantly improves velocity, cadence, and step length in people with acute stroke. The current study demonstrated that gait assessment can be incorporated into a clinical routine to evaluate gait improvements during an initial fitting of an AFO. This will be useful for patient education and training, justification to payers of medical necessity, monitoring progress, and decision making in weaning patients off an orthosis.

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