Association between kinesiophobia and walking gait characteristics in physically active individuals with anterior cruciate ligament reconstruction

Luc-Harkey, Brittney A.; Franz, Jason R.; Losina, Elena; Pietrosimone, Brian

doi:10.1016/j.gaitpost.2018.06.029

Cited by 19 publications

(25 citation statements)

References 30 publications

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“…A recent study into the relation between kinesiophobia and gaitcharacteristics in physically active individuals with ACLR failed to find significant correlations between gait-parameters and kinesiophobia (Luc-Harkey et al, 2018). However, the kinematic gait-parameters in that study (self-selected gait-speed, peak ground-reaction forces and knee-flexion excursion of the ACLR-limb) were not focused on measures of motor-flexibility, whereas our study was.…”

Section: Discussioncontrasting

confidence: 72%

Changes in motor-flexibility following anterior cruciate ligament reconstruction as measured by means of a leg-amplitude differentiation task with haptic and visual feedback

Roelofsen

Cingel

Staal

et al. 2020

Clinical Biomechanics

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Background: In the current study changes in lower-limb motor flexibility of patients undergoing Anterior Cruciate Ligament Reconstruction were evaluated in relation to fear of harm. Methods: Fourteen patients were measured pre-and post-surgery, and data were compared to those of a single measurement in fifteen controls. Lower-limb motor-flexibility was assessed in treadmill-walking and a cyclic legamplitude differentiation task augmented with haptic or visual feedback. Flexibility was captured by determining the between-leg coordination-variability (SD of relative phase) and each leg's temporal variability (sample entropy). Patients were post hoc divided into a higher-fear-group (pre-surgery: n = 6, post-surgery: n = 7) and a lower-fear-group (pre-surgery: n = 6, post-surgery: n = 7) by means of a median split of their scores on a self-reported fear of harm scale. Differences in flexibility-measures between the higher-fear-group and the lowerfear-group were also assessed. Findings: No pre-and post-surgery differences, nor differences with the control group, were found in motorflexibility during treadmill-walking but the post-surgery higher-fear-group did show lower values of SD relative phase. In the leg-amplitude differentiation task the SD of the relative phase decreased but sample entropy increased post-surgery towards levels of the control-group. The pre-surgery higher-fear-group showed lower values of sample entropy in visual conditions. Interpretation: While gait kinematics may not show motor-flexibility changes following anterior cruciate ligament reconstruction, a leg-amplitude differentiation task does show such changes. Differentiating patients on a fear-ofharm scale revealed subtle differences in motor-flexibility. Challenging patients with non-preferred movements such as amplitude differentiation may be a promising tool to evaluate motor-flexibility following ACLR.

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Section: Discussioncontrasting

confidence: 72%

Changes in motor-flexibility following anterior cruciate ligament reconstruction as measured by means of a leg-amplitude differentiation task with haptic and visual feedback

Roelofsen

Cingel

Staal

et al. 2020

Clinical Biomechanics

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“…( 24) It is possible pain-related fear of movement may play a role in the altered movement patterns found between those with and without symptoms in the first 12 months following ACLR. Yet, recent work has found kinesiophobia does not associate with peak gait mechanics in the first 50% of stance in individuals with an ACLR, (25) suggesting that fear of pain with movement may not have a strong influence on limb loading during walking in individuals who have returned to unrestricted activity. Abnormal vGRF during any part of stance, including the middle and final third could detrimentally influence knee joint health, (26,27) and should be quantified in this context, throughout the stance phase, rather than only during impact loading.…”

Section: Discussionmentioning

confidence: 99%

Walking Ground Reaction Force Post-ACL Reconstruction: Analysis of Time and Symptoms

Pietrosimone

Seeley

Johnston

et al. 2019

Medicine &Amp; Science in Sports &Amp; Exercise

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Relative to asymptomatic individuals, symptomatic individuals are more likely to underload the ACLR limb early following ACLR (i.e., <12 months) during both vGRF peaks, but overload the ACLR limb, during both vGRF peaks, at later time points (i.e., >24 months). We propose these differences in lower extremity loading during walking might have implications for long-term knee health, and should be considered when designing therapeutic interventions for individuals with an ACLR.

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“…The TSK-17 is a 17-item scale commonly used to estimate movement-related fear. 19,24,26 This PROM was originally developed to "discriminate between non-excessive fear and phobia among patients with chronic musculoskeletal pain." 27 To specifically address the fear of reinjury, we used 1 statement from the TSK-17, Q9: "I am afraid that I might injure myself accidently", which has four response options: "strongly disagree", "disagree", "agree", and "strongly agree".…”

Section: [H2]participantsmentioning

confidence: 99%

Fear of Reinjury Following Anterior Cruciate Ligament Reconstruction Is Manifested in Muscle Activation Patterns of Single-Leg Side-Hop Landings

2021

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Objective The purpose of this study was to determine whether fear of re-injury is manifested in joint kinematics and muscle activation patterns during landings of a standardized rebound side-hop (SRSH), or in patient-reported outcome measures (PROMs), among individuals with anterior cruciate ligament reconstruction (ACLR). Methods In this cross-sectional observational study, 38 individuals within 2 years post-ACLR were grouped into HIGH-FEAR (n = 21, median 11.2 months post-surgery) or LOW-FEAR (n = 17, median 10.1 months post-surgery) based on a discriminating question (Q9; Tampa Scale of Kinesiophobia-17). These individuals and 39 asymptomatic controls performed the SRSH. Three-dimensional motion recordings were used to calculate trunk, hip, and knee joint angles at initial contact, and range of respective joint motion during landing. Surface electromyography registered mean amplitudes and co-contraction indexes for thigh muscles during pre-activation (50 ms) and landing phases. PROMs of knee function, knee health, and physical activity were also analyzed. Results The HIGH-FEAR and LOW-FEAR classification was corroborated by distinct Tampa Scale of Kinesiophobia-17 total and subscale scores and revealed distinguishable muscle activation patterns. HIGH-FEAR demonstrated higher biceps femoris electromyography amplitude and higher anterior-posterior co-contraction index during landing than both LOW-FEAR and controls. However, there were no fear-related differences for kinematics or PROMs. Instead, both ACLR subgroups showed different kinematics at initial contact to controls; HIGH-FEAR with more trunk, hip, and knee flexion, and LOW-FEAR with more hip and knee flexion. Conclusion Individuals with ACLR who had high fear of re-injury seem to have adopted a protective strategy with higher muscular activation patterns, presumably to stabilize the knee joint, compared to individuals with low fear of re-injury and controls. SRSH landing kinematics or knee-related PROMs may not be as sensitive to fear of re-injury. Impact Fear of reinjury following anterior cruciate ligament (ACL) injury should be evaluated as an independent psychological outcome throughout rehabilitation after ACLR for improved return to sport transition. Lay Summary If you have an ACL injury treated with reconstructive surgery, you might have a high fear of reinjury, and that can change how you activate the muscles around your knee. Your physical therapist can do a simple screening test in addition to functional tests to help reduce your fear and improve your treatment outcomes.

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Association between kinesiophobia and walking gait characteristics in physically active individuals with anterior cruciate ligament reconstruction

Abstract: These data do not support that kinesiophobia is a critical factor contributing to walking gait characteristics in physically active individuals with ACLR.

Cited by 19 publications

References 30 publications

Changes in motor-flexibility following anterior cruciate ligament reconstruction as measured by means of a leg-amplitude differentiation task with haptic and visual feedback

Changes in motor-flexibility following anterior cruciate ligament reconstruction as measured by means of a leg-amplitude differentiation task with haptic and visual feedback

Walking Ground Reaction Force Post-ACL Reconstruction: Analysis of Time and Symptoms

Fear of Reinjury Following Anterior Cruciate Ligament Reconstruction Is Manifested in Muscle Activation Patterns of Single-Leg Side-Hop Landings

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