Kinematic and kinetic gait deviations in males long after anterior cruciate ligament reconstruction

Milandri, Giovanni; Posthumus, Mike; Small, Teri; Bothma, Adam; Merwe, Willem van der; Kassanjee, Reshma; Sivarasu, Sudesh

doi:10.1016/j.clinbiomech.2017.07.012

Cited by 15 publications

(23 citation statements)

References 24 publications

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“…While the walking speed of our participants is comparable to previous work, 5 it differs from other studies reporting gait speed in individuals with ACLR. 24 Future studies are needed to determine the associations between walking speed and kinesiophobia in individuals with ACLR who demonstrate various self-selected walking speeds. It is possible that a more physically demanding task would have revealed a more prominent association between joint biomechanics and measures of kinesiophobia.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…Although unexpected, this may be a result of the cycle training being in the sagittal plane, with no specific training targeting the frontal plane of motion. In this variable, larger between-limb effect sizes were found in running than walking, as found long after ACLR 37 between limbs and compared with healthy controls. While run testing is not common in ACLR research, this stronger signal holds promise for tracking osteoarthritis risk, as it is an autonomic, repetitive, higher-intensity activity that most patients can perform.…”

Section: Discussionmentioning

confidence: 72%

“…Before the start of the trial, the sample size calculation yielded 18 patients per group, based on knee flexion angle differences of a previous study, 37 with an SD of 4.0°. However, on early completion of this trial, the SD was much lower at 2.4°, yielding post hoc power for knee flexion angle >90% (α = .05).…”

Section: Discussionmentioning

confidence: 99%

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A Randomized Controlled Trial of Eccentric Versus Concentric Cycling for Anterior Cruciate Ligament Reconstruction Rehabilitation

Milandri

Sivarasu

2021

Am J Sports Med

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Background: Persistent strength and biomechanical deviations remain after anterior cruciate ligament reconstruction (ACLR). Eccentric training may reduce these and associated reinjury or osteoarthritis risks. Hypothesis: For male patients who have undergone ACLR, eccentric training is more effective than concentric training at improving knee flexion angle and other biomechanical deviations, as well as strength and patient-reported outcomes, using a matched perceived exertion dose. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 26 men, 10-16 weeks after hamstring tendon graft ACLR, were randomized to an eccentric training group or a concentric control group. Both groups trained 3 times a week for 8 weeks using the same isokinetic cycle ergometer in a matched studio environment. Exercise dose was matched in training frequency, time, progression, and intensity using a target rating of perceived exertion. Baseline and follow-up testing included questionnaires, dynamometer strength testing, and walk/run gait analysis. Results: Eccentric training increased knee (+2.1°; P = .022) and hip (+2.1°; P = .010) flexion angles more than concentric training but not more than the minimal clinically important difference of 3°. Very large asymmetries in baseline knee abduction moment (walk, −0.10 N·m/kg/m; run, −0.54 N·m/kg/m) had not changed in either group by follow-up. Knee valgus angle effects were mixed. Tibial rotation angle increased in both groups, but concentric training was more effective at promoting symmetry ( P < .001). Both groups had similar increases in affected limb quadriceps strength and knee flexion moments during walk/run gait (by 20% to 33%). Hamstring strength increased in the eccentric group (+15.4%) but not the concentric group. Eccentric group limb forces were 33% to 70% higher than those of the concentric group, with a lower heart rate. Both groups had low pain scores throughout. Conclusion: For rehabilitation after ACLR, progressive eccentric cycle training was not more clinically effective than concentric training at a matched perceived intensity dose in male patients. This can guide exercise prescription for reducing gait and strength deviations of these patients. Registration: PACTR201602001449365 (Pan African Clinical Trials Registry), NHREC 4344 (South African).

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“…This momentum is stopped by a stiff front leg, which causes an external varus torque. Both varus and valgus (0.14 Nm/kg BM) torques in hitting are higher than values found in walking but considerably lower than in jogging [30,31], therefore if the patient is jogging without issue, the concern over varus or valgus torques is moot. The higher extension torque (0.20 Nm/kg BM) may be significant, because when combined with hip flexion this places the knee in a vulnerable position for hyperextension ACL injury mechanisms described by Boden and colleagues [32,33].…”

Section: Discussionmentioning

confidence: 84%

Knee Kinetics in Baseball Hitting and Return to Play after ACL Reconstruction

et al. 2020

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The purpose of this study was to describe the knee kinetics of baseball hitting, develop a tool to predict knee kinetics from easily obtainable measures, and to compare knee kinetics to other exercises along the rehabilitation continuum to determine a timeline for when hitting may resume after ACL reconstruction. Nineteen high school baseball athletes (16.3±0.8 yrs, 180.6±5.7 cm, 78.4±10.8 kg) participated. Participants took ten swings off a tee. Kinetic data were recorded using an electromagnetic tracking system. Data from swings with the top three exit velocities were averaged for analysis. Linear regressions were used to determine if predictors of height, mass, age and exit velocity could predict the following torques: bilateral knee net, extension, internal and external rotation, valgus and varus torque; and anterior force. Backwards regression models revealed independent variables could significantly predict front knee net, internal and external rotation, extension, and varus torque, and anterior force; and back knee net and valgus torque. Based on the kinetics of baseball hitting compared to those of rehabilitation exercises, if the involved knee is the front, we suggest tee hitting may be initiated at 13 weeks after ACL reconstruction. If the involved knee is the back, we suggest tee hitting may initiated at 17 weeks after ACL reconstruction.

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Kinematic and kinetic gait deviations in males long after anterior cruciate ligament reconstruction

Cited by 15 publications

References 24 publications

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

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

A Randomized Controlled Trial of Eccentric Versus Concentric Cycling for Anterior Cruciate Ligament Reconstruction Rehabilitation

Knee Kinetics in Baseball Hitting and Return to Play after ACL Reconstruction

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