Citation

Lepley AS, Gribble PA, Thomas AC, Tevald MA, Sohn DH, Pietrosimone BG. Med. Sci. Sports Exerc. 2015; 48(1): 7-15.

Affiliation

1Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky; 2Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky; 3Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, North Carolina; 4Department of Rehabilitation Sciences, University of Toledo, Toledo, Ohio; 5Department of Orthopedic Surgery, University of Toledo, Toledo, Ohio; 6Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1249/MSS.0000000000000741

PMID

26225766

Abstract

PURPOSE: Following anterior cruciate ligament (ACL) injury and reconstruction, abnormal biomechanics during daily tasks may have prominent and detrimental long-term consequences on knee joint health. The purpose of this study was to longitudinally evaluate hip and knee joint biomechanics during stair ascent and descent in acutely ACL injured patients, and at return to activity following ACL reconstruction.

METHODS: Twenty unilateral ACL injured individuals (age: 20.9 ± 4.4yrs; height: 172.4 ± 7.5cm; mass: 76.2 ± 12.2kg) that were scheduled to undergo surgical reconstruction were compared to 20 healthy matched controls (age: 21.7 ± 3.7yrs; height: 173.7 ± 9.9cm; mass: 76.1 ± 19.7kg). Lower extremity biomechanics were recorded using 3-D motion analysis during stair ascent and descent at two testing sessions (prior to surgery and at approximately 6-months post surgery, or when they were allowed to return to unrestricted physical activity). Time between sessions for healthy participants was matched based to the ACL group. Peak sagittal and frontal plane knee and hip joint angles and moments, joint angles at initial contact and joint excursions across stance phase were evaluated.

RESULTS: The injured limb of ACL patients experienced smaller knee extension moments than the uninjured limb and healthy controls during stair ascent and descent (P < 0.05) before and 6-months following ACL reconstruction. During stair ascent, ACL patients experienced more extended knee joint positions and less sagittal plane knee joint excursions, coupled with greater frontal plane hip joint excursions (P < 0.05).

CONCLUSIONS: ACL patients experience reductions in knee flexion angle and knee extension moments during stair walking. These alterations were observed both prior to, and following reconstruction, suggesting that early gait retraining interventions may be beneficial in these patients.

Language: en