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

Abstract

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.

Inter-limb asymmetry of kinetic and electromyographic during walking in patients with chronic ankle instability

“…The inter-limb asymmetry for the variables of vGRF or muscles activity was calculated using an equation from previous studies 49 , 50 : Asymmetry Index = (injured (or dominant) limb − uninjured (or non-dominant) limb) × 2/ (injured (or dominant) limb + uninjured (or non-dominant) limb) × 100%. Therefore, a negative asymmetry would be indicative of a higher value for the uninjured (or non-dominant) limb.…”

Relationship between Kinesiophobia and Ankle Joint Position Sense and Postural Control in Individuals with Chronic Ankle Instability—A Cross-Sectional Study

“…Kinesiophobia, also called “fear of movement or activity,” is defined as an excessive fear of physical movement, expecting or feeling of vulnerability to painful injury [ 17 ]. A reciprocal process occurs, resulting in a vicious cycle of negative thoughts and experiences, resulting in fear of movement, kinesiophobia, and catastrophic behavior [ 18 , 19 , 20 , 21 ]. Fear of movement may contribute to decreased muscular strength, increased postural sway, and impaired proprioception in musculoskeletal disorders [ 22 , 23 , 24 ].…”

The Muscle Strength of the Knee Joint after ACL Reconstruction Depends on the Number and Frequency of Supervised Physiotherapy Visits

“…Statistically, for every 100,000 people, isolated ACL tears occur in 70 knees [2] This problem is important for public health policy because it often concerns the treatment of people who are professionally and physically active, which is related to health, economic, and social aspects. Inadequate orthopedic and physiotherapeutic treatment promotes the occurrence of re-injuries of the knee joints, which in turn increases the costs and time of treatment, reduces its effectiveness, causes absenteeism in sports and professional work, and, in the long term, contributes to the earlier occurrence of osteoarthritis, a common disease in the population [3,4].…”