Background
We have previously reported that an eccentrically-based
rehabilitation protocol post-ACLr induced greater quadriceps activation and
strength than a neuromuscular electrical stimulation (NMES) intervention and
was just as effective as a combined NMES and eccentric intervention.
However, the effect an eccentrically-based intervention has on restoring
normal knee mechanics during a single-legged landing task remains
unknown.
Methods
Thirty-six individuals post-injury were placed into four treatment
groups: NMES and eccentrics, eccentrics-only, NMES-only, standard of care,
and Healthy controls participated. NMES and eccentrics received a combined
NMES and eccentric protocol post-reconstruction (each treatment 2x per week
for 6 wks), whereas groups NMES-only and eccentric-only received only the
NMES or eccentric therapy, respectively. To evaluate knee mechanics limb
symmetry, the area under the curve for knee flexion angle and extension
moment was derived and then normalized to the contralateral limb. Quadriceps
strength was evaluated using the quadriceps index.
Findings
Compared to Healthy, reduced sagittal plane knee limb symmetry was
found for groups NMES-only, ECC-only and standard of care for knee extension
moment (P<0.05). No difference was detected between Healthy and NMES
and eccentrics (P>0.06). No difference between groups was detected
for knee flexion angle limb symmetry (P>0.05). Greater knee flexion
angles and moments over stance were related to quadriceps strength.
Interpretation
The NMES and eccentrics group was found to restore biomechanical limb
symmetry that was most closely related to Healthy individuals following ACL
reconstruction. Greater knee flexion angles and moments over stance were
related to quadriceps strength.