Evaluation of lower limb kinetics during gait, sprint and hop tests before and after anterior cruciate ligament reconstruction

Abstract

BackgroundThe purpose of this study was to evaluate the functional status prior to and at different times after anterior cruciate ligament reconstruction (ACLR), and to analyze the changes in the kinetic patterns of the involved and uninvolved lower limb during gait, sprint and three hop tests.Materials and methodsSeventy-four male patients with an ACL injury were included in the study. All patients performed a standardized kinetic protocol including gait, sprint and three hop tests (single-leg hop, drop vertical jump and vertical jump tests), preoperatively and at 3, 6, and 12 months after ACLR with a semitendinosus gracilis tendon autograft. Measurements were performed with two force plates. The lower limb symmetry index (LSI) was calculated to determine whether a side-to-side leg difference was classified as normal (LSI >90%) or abnormal (LSI <90%).ResultsThe LSI presented high values (>90%) at almost all times before and after ACLR in gait, sprint and single-leg hop tests (p < 0.005), with a tendency to increase postoperatively. A lower LSI was observed (<90%) in tests where both extremities were tested simultaneously, such as the drop vertical jump and vertical hop tests (p < 0.05).ConclusionWe observed a tendency to increase symmetry restoration in the kinetics of the involved and uninvolved limb up to twelve months after ACLR, especially in those tests, in which, both limbs were tested individually (gait analysis, sprint and single-leg hop tests). Therefore, the isolation of the involved and uninvolved limb seems to be a critical component in the functional rehabilitation and evaluation of patients before and after ACLR.Level of evidencelevel III.

Measuring only hop distance during single leg hop testing is insufficient to detect deficits in knee function after ACL reconstruction: a systematic review and meta-analysis

“…The full texts of 60 articles were assessed for eligibility according to the inclusion/exclusion criteria. Finally, 19 articles25–43 met the inclusion criteria of the present review (figure 1).…”

“…Eighteen of the 19 included studies had a cross-sectional design25–32 34–43 and one had a prospective design 33. A total of 624 ACLR patients (424 men, 200 women; mean age 30 years) as well as 315 controls (208 men, 107 women; mean age 27.6 years) were included in the review (table 1).…”

“…In 13 studies, biomechanical outcomes were compared with the contralateral leg and in 12 studies with a control group. Sixteen studies25 27–32 35–43 reported kinematics of the SLHD test, eight studies26 30 33 35 36 39 41 42 reported kinetics and four studies25 27 30 34 reported EMG data. Only two studies27 30 simultaneously collected kinematics, kinetics and EMG, but one27 used a mixed group of healthy and ACLR patients and compared different landing strategies, whereas another30 reported kinematics and kinetics in a mixed group of healthy and ACLR subjects (due to missing data).…”

Patients With Abnormal Limb Kinetics at 6 Months After Anterior Cruciate Ligament Reconstruction Have an Increased Risk of Persistent Medial Meniscal Abnormality at 3 Years

“…37 The biomechanical findings during landing in the current study are also consistent with previous work that assessed 1-year longitudinal changes in peak ipsilateral VGRF of patients with ACLR during a drop jump task. 29 At 3 years, the patients with ACLR exhibited similar peak VGRF and KFM Figure 3. (A) Correlation between peak vertical ground-reaction force (VGRF) at 6 months and change in T1r value in the posterior horn of the medial meniscus (PHMED) from 6 months to 3 years in the anterior cruciate ligament reconstruction (ACLR) cohort.…”

ALICE: Conceptual Development of a Lower Limb Exoskeleton Robot Driven by an On-Board Musculoskeletal Simulator

“…Each person has his/her own inherent pattern for walking, using different postural, neuromuscular, locomotor, and dynamic balance control. Some studies [44][45][46] showed there were different patterns for healthy people and many others differed under some pathological condition. Moreover, these patterns depended on external parameters such as velocity and contact surfaces.…”