Biomechanical effects of manipulating peak vertical ground reaction force throughout gait in individuals 6–12 months after anterior cruciate ligament reconstruction

Evans‐Pickett, Alyssa; Davis-Wilson, Hope; Luc-Harkey, Brittney A.; Blackburn, J. Troy; Franz, Jason R.; Padua, Darin A.; Seeley, Matthew K.; Pietrosimone, Brian

doi:10.1016/j.clinbiomech.2020.105014

Cited by 25 publications

(34 citation statements)

References 58 publications

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“…The vGRF, however, can be measured with relative ease using a single force plate outside of a gait laboratory setting or possibly even remotely using pressure‐sensitive insoles, 37,38 has been shown to have excellent reliability and low variability during walking, 39–41 and is of interest as a biomechanical variable of interest. Recent work shows that the vGRF can be modified post‐ACL reconstruction, 42,43 and thus, it is also a potential therapeutic target.…”

Section: Discussionmentioning

confidence: 99%

“…The vGRF, however, can be measured with relative ease using a single force plate outside of a gait laboratory setting or possibly even remotely using pressure-sensitive insoles, 37,38 has been shown to have excellent reliability and low variability during walking, [39][40][41] and is of interest as a biomechanical variable of interest. Recent work shows that the vGRF can be modified post-ACL reconstruction, 42,43 and thus, it is also a potential therapeutic target. Abbreviations: ADL, activities of daily living; BMI, body mass index; IKDC, International Knee Documentation Committee; QOL, quality of life; Sports/Rec, sports and recreation; vGRF, vertical ground reaction force.…”

Section: Symptomatic Progressionmentioning

confidence: 99%

See 1 more Smart Citation

Vertical ground reaction force 2 years after anterior cruciate ligament reconstruction predicts 10‐year patient‐reported outcomes

Erhart‐Hledik

Chu

Asay

et al. 2021

Journal Orthopaedic Research

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Disruptions in knee biomechanics during walking following anterior cruciate ligament (ACL) injury have been suggested to lead to the development of premature knee osteoarthritis (OA) and to be potential markers of OA risk and targets for intervention. This study investigated if side‐to‐side differences in early stance peak vertical ground reaction force (vGRF) during walking 2 years after ACL reconstruction are associated with longer‐term (10 years post‐reconstruction) changes in patient‐reported outcomes. Twenty‐eight participants (mean age: 28.7 ± 6.4 years) with primary unilateral ACL reconstruction underwent gait analysis for assessment of peak vGRF and completed Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) surveys at 2 years post‐surgery (2.2 ± 0.3 years) and completed surveys at follow‐up 10 years post‐surgery (10.5 ± 0.9 years). Associations between changes (10–2 years) in patient‐reported outcomes and between limb‐differences in vGRF were assessed with Pearson or Spearman's ρ correlation coefficients and exploratory backwards elimination multiple linear regression analyses. Differences in vGRF between symptomatic progressors and non‐progressors were also assessed. The side‐to‐side difference in vGRF was related to the variability in longer‐term changes in patient‐reported outcome metrics and distinguished symptomatic progressors from non‐progressors. Participants with higher vGRF in the reconstructed (ACLR) limb versus the contralateral limb had worsening of IKDC (R = −0.391, p = 0.040), KOOS pain (ρ = −0.396, p = 0.037), KOOS symptoms (ρ = −0.572, p = 0.001), and KOOS quality of life (R = −0.458, p = 0.014) scores at follow‐up. Symptomatic progressors had greater vGRF in the ACLR limb as compared to the contralateral limb at baseline than non‐progressors (p = 0.023). These data highlight associations between a simple‐to‐measure gait metric and the development of long‐term clinical symptoms after an ACL injury.

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Section: Discussionmentioning

confidence: 99%

Section: Symptomatic Progressionmentioning

confidence: 99%

Vertical ground reaction force 2 years after anterior cruciate ligament reconstruction predicts 10‐year patient‐reported outcomes

Erhart‐Hledik

Chu

Asay

et al. 2021

Journal Orthopaedic Research

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“…Force-Measuring Treadmills (Measurement System 2): Six studies used force-measuring treadmills in gait assessment and reported 8 parameters including vGRF [50,58,98], vGRF limb symmetry index [98], peak vGRF [96,97], peak vGRF normalized to body weight [113], instantaneous vGRF loading rate [96,98], instantaneous vGRF loading rate normalized to body weight [97] instantaneous vGRF loading rate limb symmetry index [97], and root mean square error between actual vGRF and biofeedback target vGRF [96].…”

Section: Gaitmentioning

confidence: 99%

Kinetic measurement system use in individuals following anterior cruciate ligament reconstruction: a scoping review of methodological approaches

et al. 2021

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Purpose Our primary objectives were to (1) describe current approaches for kinetic measurements in individuals following anterior cruciate ligament reconstruction (ACLR) and (2) suggest considerations for methodological reporting. Secondarily, we explored the relationship between kinetic measurement system findings and patient-reported outcome measures (PROMs). Methods We followed the PRISMA extension for scoping reviews and Arksey and O’Malley’s 6-stage framework. Seven electronic databases were systematically searched from inception to June 2020. Original research papers reporting parameters measured by kinetic measurement systems in individuals at least 6-months post primary ACLR were included. Results In 158 included studies, 7 kinetic measurement systems (force plates, balance platforms, pressure mats, force-measuring treadmills, Wii balance boards, contact mats connected to jump systems, and single-sensor insoles) were identified 4 main movement categories (landing/jumping, standing balance, gait, and other functional tasks). Substantial heterogeneity was noted in the methods used and outcomes assessed; this review highlighted common methodological reporting gaps for essential items related to movement tasks, kinetic system features, justification and operationalization of selected outcome parameters, participant preparation, and testing protocol details. Accordingly, we suggest considerations for methodological reporting in future research. Only 6 studies included PROMs with inconsistency in the reported parameters and/or PROMs. Conclusion Clear and accurate reporting is vital to facilitate cross-study comparisons and improve the clinical application of kinetic measurement systems after ACLR. Based on the current evidence, we suggest methodological considerations to guide reporting in future research. Future studies are needed to examine potential correlations between kinetic parameters and PROMs.

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“…The vertical GRF during gait is often used as an estimate of the total load applied up through the lower limbs in individuals with ACL reconstruction, 1,2,[5][6][7][8] and recent work has shown this gait parameter is a viable target for gait interventions using real-time biofeedback paradigms. 2,32 However, evaluation of other components of the GRF during walking, such as the posterior-anterior GRF, have received far less attention in the literature despite evidence suggesting this parameter may provide additional insight into the extent of biomechanical asymmetries present after surgery. For example, Lim et al 33,34 demonstrated the magnitude of asymmetry in the posterior (breaking) GRF was substantially higher than that seen in the vertical GRF component (i.e., 11% vs. 4%).…”

Section: Introductionmentioning

confidence: 99%

Gait asymmetries are exacerbated at faster walking speeds in individuals with acute anterior cruciate ligament reconstruction

Garcia

Brown

Koje

et al. 2021

Journal Orthopaedic Research

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Previous research suggests more biomechanically demanding tasks (e.g., stair descent, hopping) magnify biomechanical asymmetries compared with walking after anterior cruciate ligament (ACL) reconstruction. However, it is unclear if modifying task‐specific constraints, like walking speed also elicits greater biomechanical asymmetries in this population. We examined the effects of manipulating walking speed on ground reaction force (GRF) asymmetries in individuals with ACL reconstruction and uninjured controls. Thirty individuals with ACL reconstruction (age = 20.6 ± 5.4 years, body mass index [BMI] = 23.9 ± 3.3 kg/m2) and 15 controls (age = 23.1 ± 4.5 years, BMI = 23.6 ± 2.7 kg/m2) were tested on an instrumented treadmill at three speeds (100%, 120%, and 80% self‐selected speed). Bilateral vertical and posterior‐anterior GRFs were recorded at each speed. GRF asymmetries were calculated by subtracting the uninjured from the injured limb at each percent of stance. Statistical parametric mapping was used to evaluate the effects of speed on GRF asymmetries across stance. We found vertical and posterior GRF asymmetries were exacerbated at faster speeds and reduced at slower speeds in ACL individuals but not controls (p < .05). No differences in anterior GRF asymmetries were observed between speeds in either group (p > .05). Our results suggest increasing walking speed magnifies GRF asymmetries in individuals with ACL reconstruction. Statement of Clinical Significance: Evaluating both preferred and fast walking speeds may aid in characterizing biomechanical asymmetries in individuals with ACL reconstruction which may be valuable in earlier rehabilitative time points when more difficult tasks like hopping and running are not feasible.

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Biomechanical effects of manipulating peak vertical ground reaction force throughout gait in individuals 6–12 months after anterior cruciate ligament reconstruction

Cited by 25 publications

References 58 publications

Vertical ground reaction force 2 years after anterior cruciate ligament reconstruction predicts 10‐year patient‐reported outcomes

Vertical ground reaction force 2 years after anterior cruciate ligament reconstruction predicts 10‐year patient‐reported outcomes

Kinetic measurement system use in individuals following anterior cruciate ligament reconstruction: a scoping review of methodological approaches

Gait asymmetries are exacerbated at faster walking speeds in individuals with acute anterior cruciate ligament reconstruction

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