Anterior cruciate ligament reconstruction results in alterations in gait variability

Moraiti, Constantina; Stergiou, Nicholas; Vasiliadis, Haris S.; Motsis, E.; Georgoulis, Anastasios D.

doi:10.1016/j.gaitpost.2010.04.008

Cited by 76 publications

(79 citation statements)

References 44 publications

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“…However, it has never been studied whether joint angles would be even better input variables than trunk kinematics. Indeed, some studies investigating stability in patients with knee osteoarthritis and anterior cruciate ligament ruptures have used knee angle time series [37,40,42,49,50,59,72,[86][87][88][89]. The idea behind the studies in these patients was either that the main mode of instability arises from buckling or giving way of the knee joint [87] or that joint movements reflect coordination of the segments between which the joint is situated [37,40,42,49,50,59,72,86,88,89].…”

Section: Calculationmentioning

confidence: 99%

Assessing the stability of human locomotion: a review of current measures

Bruijn

Meijer

Beek³

et al. 2013

J. R. Soc. Interface.

531

365

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Falling poses a major threat to the steadily growing population of the elderly in modern-day society. A major challenge in the prevention of falls is the identification of individuals who are at risk of falling owing to an unstable gait. At present, several methods are available for estimating gait stability, each with its own advantages and disadvantages. In this paper, we review the currently available measures: the maximum Lyapunov exponent (l S and l L ), the maximum Floquet multiplier, variability measures, long-range correlations, extrapolated centre of mass, stabilizing and destabilizing forces, foot placement estimator, gait sensitivity norm and maximum allowableperturbation. We explain what these measures represent and how they are calculated, and we assess their validity, divided up into construct validity, predictive validity in simple models, convergent validity in experimental studies, and predictive validity in observational studies. We conclude that (i) the validity of variability measures and l S is best supported across all levels, (ii) the maximum Floquet multiplier and l L have good construct validity, but negative predictive validity in models, negative convergent validity and (for l L ) negative predictive validity in observational studies, (iii) long-range correlations lack construct validity and predictive validity in models and have negative convergent validity, and (iv) measures derived from perturbation experiments have good construct validity, but data are lacking on convergent validity in experimental studies and predictive validity in observational studies. In closing, directions for future research on dynamic gait stability are discussed.

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Section: Calculationmentioning

confidence: 99%

Assessing the stability of human locomotion: a review of current measures

Bruijn

Meijer

Beek³

et al. 2013

J. R. Soc. Interface.

531

365

View full text Add to dashboard Cite

show abstract

“…22 Although ACLR is considered a relatively successful procedure that results in return to premorbid activity levels in a majority of patients, 39 it has been reported that muscle strength deficits, as well as kinematic and kinetic deficits, persist even after a patient's successful return to sport. 14,15,17,26,38,46 This is particularly concerning given the high demands placed on the knee joint during high-intensity sports and may explain the high reinjury rates that have been widely observed among athletes who have undergone ACLR. 7 Among the many assessment tools commonly used to determine returnto-sport status in this population, the U U STUDY DESIGN: Within-subject and betweensubject cross-sectional study.…”

mentioning

confidence: 99%

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Xergia

Pappas²,

Zampeli³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

127

131

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Study Design Within-subject and between-subject cross-sectional study. Objectives To investigate symmetry in hop-test performance, strength, and lower extremity kinematics 6 to 9 months following anterior cruciate ligament reconstruction (ACLR). Background Despite the extensive body of literature involving persons following ACLR, no study has comprehensively evaluated measures of strength, lower extremity kinematics, and functional performance of functional hop tests in this population. Methods The subjects were 22 men (mean ± SD age, 28.8 ± 11.2 years) who had ACLR using a bone-patellar tendon-bone autograft 6 to 9 (7.01 ± 0.93) months previously and 22 healthy male controls (age, 24.8 ± 9.1 years). Participants completed a self-report questionnaire and underwent isokinetic strength testing and functional and kinematic assessment of the single-, triple-, and crossover-hop tests. Two-way analyses of variance were used to test for differences between the ACLR group and the control group, and between the 2 lower extremities of the ACLR group. Results Compared to the control group, the ACLR group had greater isokinetic knee extension torque deficits at all speeds (P≤.001) and greater performance asymmetry for all 3 hop tests (P<.001). Compared to the noninvolved lower extremity, the involved lower extremity of the ACLR group exhibited less ankle dorsiflexion and knee flexion in the phases of propulsion (P≤.014) and landing (P≤.032). When compared to the control group, the involved lower extremity exhibited less ankle dorsiflexion in the propulsion phase (P<.001) but higher hip flexion in the landing phase (P = .014). Conclusion Six to 9 months following ACLR, patients continue to demonstrate functional hop and isokinetic knee extension deficits, as well as kinematic differences, during the propulsion and landing phases of the hop tests. J Orthop Sports Phys Ther 2013;43(3):154–162. Epub 14 January 2013. doi:10.2519/jospt.2013.3967

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“…On the other hand, Moraiti et al 69 reported that patients with ACL who had undergone surgical reconstruction exhibited significantly larger Lyapunov Exponent values (more divergence in the movement trajectories during gait) than the control limbs. Bush-Joseph et al, 13 who studied a group of patients with ACL deficiency 8 months after repair surgery, reported only minor reductions in peak knee flexion, owing to the return of normal muscle activity.…”

Section: Gait Variability Of Acute Acl Deficiencymentioning

confidence: 99%

Pre-Operative versus Post-Operative Gait Variability in Patients with Acute Anterior Cruciate Ligament Deficiency

et al. 2011

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Change in gait variability at least 6 months after surgical reconstruction of the anterior cruciate ligament (ACL) was assessed in 20 male patients with acute ACL deficiency and compared with preoperative data and that from 20 healthy male controls. Gait was measured using a triaxial accelerometer and data were analysed by the Gait Evaluation Differential Entropy Method (GEDEM) to determine gait variability. Pain was assessed with a visual analogue scale and functional ability with the Oswestry Disability Index and the International Knee Documentation Committee score.Mean gait variability was significantly lower after than before surgery, with values for the anterior-posterior axis being in the normal range of controls after 6 months, whereas in the mediolateral axis mean gait variability remained significantly higher, indicating that some rotational instability remained in the time-frame of the study. Pain and functional ability scores improved after surgery compared with before surgery. The combination of accelerometry and GEDEM may be a useful orthopaedic tool for the post-operative evaluation of patients who have undergone ACL reconstruction.

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Anterior cruciate ligament reconstruction results in alterations in gait variability

Cited by 76 publications

References 44 publications

Assessing the stability of human locomotion: a review of current measures

Assessing the stability of human locomotion: a review of current measures

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Pre-Operative versus Post-Operative Gait Variability in Patients with Acute Anterior Cruciate Ligament Deficiency

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