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Mausehund L, Krosshaug T. Knee Biomechanics During Cutting Maneuvers and Secondary ACL Injury Risk: A Prospective Cohort Study of Knee Biomechanics in 756 Female Elite Handball and Soccer Players. Am J Sports Med 2024; 52:1209-1219. [PMID: 38459717 PMCID: PMC10986153 DOI: 10.1177/03635465241234255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 12/18/2023] [Indexed: 03/10/2024]
Abstract
BACKGROUND An athlete who returns to sport after an anterior cruciate ligament (ACL) injury has a substantially high risk of sustaining a new secondary ACL injury. Because ACL injuries most frequently occur during cutting maneuvers, such movements should be at the center of research attention. PURPOSE To investigate whether knee biomechanical parameters during side-step cutting maneuvers differ between female elite athletes with and without a history of ACL injury and to evaluate whether such parameters are associated with future secondary ACL injury. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS A total of 756 female elite handball and soccer players, of whom 76 had a history of ACL injury, performed a sport-specific cutting task while 3-dimensional kinematics and kinetics were measured. ACL injuries were registered prospectively over an 8-year follow-up period. Seven knee-specific biomechanical variables were the basis for all analyses. Two-way analyses of variance were applied to assess group differences, whereas logistic regression models served to evaluate associations between the knee-specific variables and future secondary ACL injury. RESULTS When players with a previous ACL injury performed the cutting maneuver with their ipsilateral leg, they exhibited lower knee abduction angles (mean difference [MD], 1.4°-1.5°; 95% CI, 0.2°-2.9°), lower peak knee flexion moments (MD, 0.33 N·m/kg-1; 95% CI, 0.18-0.48 N·m/kg-1), lower peak knee abduction moments (MD, 0.27 N·m/kg-1; 95% CI, 0.12-0.41 N·m/kg-1), and lower peak knee internal rotation moments (MD, 0.06 N·m/kg-1; 95% CI, 0.01-0.12 N·m/kg-1) compared with injury-free players. When players performed the cut with their contralateral leg, no differences were evident (P < .05). None of the 7 knee-specific biomechanical variables was associated with future secondary ACL injury in players with an ACL injury history (P < .05). CONCLUSION Approximately 4 years after ACL injury, female elite team-ball athletes still unloaded their ipsilateral knee during cutting maneuvers, yet contralateral knee loading was similar to that of injury-free players. Knee biomechanical characteristics were not associated with future secondary ACL injury.
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Affiliation(s)
- Lasse Mausehund
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Tron Krosshaug
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Shokouhyan SM, Blandeau M, Wallard L, Barbier F, Khalaf K. Time-delay estimation in biomechanical stability: a scoping review. Front Hum Neurosci 2024; 18:1329269. [PMID: 38357009 PMCID: PMC10866002 DOI: 10.3389/fnhum.2024.1329269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Despite its high-level of robustness and versatility, the human sensorimotor control system regularly encounters and manages various noises, non-linearities, uncertainties, redundancies, and delays. These delays, which are critical to biomechanical stability, occur in various parts of the system and include sensory, signal transmission, CNS processing, as well as muscle activation delays. Despite the relevance of accurate estimation and prediction of the various time delays, the current literature reflects major discrepancy with regards to existing prediction and estimation methods. This scoping review was conducted with the aim of characterizing and categorizing various approaches for estimation of physiological time delays based on PRISMA guidelines. Five data bases (EMBASE, PubMed, Scopus, IEEE and Web of Science) were consulted between the years of 2000 and 2022, with a combination of four related categories of keywords. Scientific articles estimating at least one physiological time delay, experimentally or through simulations, were included. Eventually, 46 articles were identified and analyzed with 20 quantification and 16 qualification questions by two separate reviewers. Overall, the reviewed studies, experimental and analytical, employing both linear and non-linear models, reflected heterogeneity in the definition of time delay and demonstrated high variability in experimental protocols as well as the estimation of delay values. Most of the summarized articles were classified in the high-quality category, where multiple sound analytical approaches, including optimization, regression, Kalman filter and neural network in time domain or frequency domain were used. Importantly, more than 50% of the reviewed articles did not clearly define the nature of the estimated delays. This review presents and summarizes these issues and calls for a standardization of future scientific works for estimation of physiological time-delay.
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Affiliation(s)
| | - Mathias Blandeau
- University Polytechnique Hauts-de-France, CNRS, UMR 8201 - LAMIH, Valenciennes, France
| | - Laura Wallard
- University Polytechnique Hauts-de-France, CNRS, UMR 8201 - LAMIH, Valenciennes, France
| | - Franck Barbier
- University Polytechnique Hauts-de-France, CNRS, UMR 8201 - LAMIH, Valenciennes, France
- INSA Hauts-de-France, Valenciennes, France
| | - Kinda Khalaf
- Khalifa University of Science and Technology and Heath Innovation Engineering Center, Abu Dhabi, United Arab Emirates
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Waiteman MC, Chia L, Ducatti MHM, Bazett-Jones DM, Pappas E, de Azevedo FM, Briani RV. Trunk Biomechanics in Individuals with Knee Disorders: A Systematic Review with Evidence Gap Map and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:145. [PMID: 36503991 PMCID: PMC9742076 DOI: 10.1186/s40798-022-00536-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The trunk is the foundation for transfer and dissipation of forces throughout the lower extremity kinetic chain. Individuals with knee disorders may employ trunk biomechanical adaptations to accommodate forces at the knee or compensate for muscle weakness. This systematic review aimed to synthesize the literature comparing trunk biomechanics between individuals with knee disorders and injury-free controls. METHODS Five databases were searched from inception to January 2022. Observational studies comparing trunk kinematics or kinetics during weight-bearing tasks (e.g., stair negotiation, walking, running, landings) between individuals with knee disorders and controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and evidence gap maps were created. RESULTS A total of 81 studies investigating trunk biomechanics across six different knee disorders were included (i.e., knee osteoarthritis [OA], total knee arthroplasty [TKA], patellofemoral pain [PFP], patellar tendinopathy [PT], anterior cruciate ligament deficiency [ACLD], and anterior cruciate ligament reconstruction [ACLR]). Individuals with knee OA presented greater trunk flexion during squatting (SMD 0.88, 95% CI 0.58-1.18) and stepping tasks (SMD 0.56, 95% CI 0.13-.99); ipsilateral and contralateral trunk lean during walking (SMD 1.36; 95% CI 0.60-2.11) and sit-to-stand (SMD 1.49; 95% CI 0.90-2.08), respectively. Greater trunk flexion during landing tasks in individuals with PFP (SMD 0.56; 95% CI 0.01-1.12) or ACLR (SMD 0.48; 95% CI 0.21-.75) and greater ipsilateral trunk lean during single-leg squat in individuals with PFP (SMD 1.01; 95% CI 0.33-1.70) were also identified. No alterations in trunk kinematics of individuals with TKA were identified. Evidence gap maps outlined the lack of investigations for individuals with PT or ACLD, as well as for trunk kinetics across knee disorders. CONCLUSION Individuals with knee OA, PFP, or ACLR present with altered trunk kinematics in the sagittal and frontal planes. The findings of this review support the assessment of trunk biomechanics in these individuals in order to identify possible targets for rehabilitation and avoidance strategies. TRIAL REGISTRATION PROSPERO registration number: CRD42019129257.
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Affiliation(s)
- Marina C. Waiteman
- grid.410543.70000 0001 2188 478XDepartment of Physical Therapy, School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900 Brazil
| | - Lionel Chia
- grid.1013.30000 0004 1936 834XSydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia ,Cleveland Guardians Baseball Company, Cleveland, OH USA
| | - Matheus H. M. Ducatti
- grid.410543.70000 0001 2188 478XDepartment of Physical Therapy, School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900 Brazil
| | - David M. Bazett-Jones
- grid.267337.40000 0001 2184 944XSchool of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, Toledo, OH USA
| | - Evangelos Pappas
- grid.1007.60000 0004 0486 528XSchool of Medicine and Illawarra Health and Medical Research Institute, The University of Wollongong, Wollongong, NSW Australia
| | - Fábio M. de Azevedo
- grid.410543.70000 0001 2188 478XDepartment of Physical Therapy, School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900 Brazil
| | - Ronaldo V. Briani
- grid.410543.70000 0001 2188 478XDepartment of Physical Therapy, School of Science and Technology, Sao Paulo State University (UNESP), 305, Roberto Simonsen Street, Presidente Prudente, Sao Paulo 19060-900 Brazil
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Saueressig T, Braun T, Steglich N, Diemer F, Zebisch J, Herbst M, Zinser W, Owen PJ, Belavy DL. Primary surgery versus primary rehabilitation for treating anterior cruciate ligament injuries: a living systematic review and meta-analysis. Br J Sports Med 2022; 56:1241-1251. [PMID: 36038357 PMCID: PMC9606531 DOI: 10.1136/bjsports-2021-105359] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Compare the effectiveness of primarily surgical versus primarily rehabilitative management for anterior cruciate ligament (ACL) rupture. DESIGN Living systematic review and meta-analysis. DATA SOURCES Six databases, six trial registries and prior systematic reviews. Forward and backward citation tracking was employed. ELIGIBILITY CRITERIA Randomised controlled trials that compared primary reconstructive surgery and primary rehabilitative treatment with or without optional reconstructive surgery. DATA SYNTHESIS Bayesian random effects meta-analysis with empirical priors for the OR and standardised mean difference and 95% credible intervals (CrI), Cochrane RoB2, and the Grading of Recommendations Assessment, Development and Evaluation approach to judge the certainty of evidence. RESULTS Of 9514 records, 9 reports of three studies (320 participants in total) were included. No clinically important differences were observed at any follow-up for self-reported knee function (low to very low certainty of evidence). For radiological knee osteoarthritis, we found no effect at very low certainty of evidence in the long term (OR (95% CrI): 1.45 (0.30 to 5.17), two studies). Meniscal damage showed no effect at low certainty of evidence (OR: 0.85 (95% CI 0.45 to 1.62); one study) in the long term. No differences were observed between treatments for any other secondary outcome. Three ongoing randomised controlled trials were identified. CONCLUSIONS There is low to very low certainty of evidence that primary rehabilitation with optional surgical reconstruction results in similar outcome measures as early surgical reconstruction for ACL rupture. The findings challenge a historical paradigm that anatomic instability should be addressed with primary surgical stabilisation to provide optimal outcomes. PROSPERO REGISTRATION NUMBER CRD42021256537.
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Affiliation(s)
- Tobias Saueressig
- Science and Research, Physio Meets Science GmbH, Leimen, Baden-Württemberg, Germany
| | - Tobias Braun
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit, Bochum, North Rhine-Westphalia, Germany
- HSD Hochschule Döpfer (University of Applied Sciences), Cologne, North Rhine-Westphalia, Germany
| | - Nora Steglich
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit, Bochum, North Rhine-Westphalia, Germany
| | | | - Jochen Zebisch
- Science and Research, Physio Meets Science GmbH, Leimen, Baden-Württemberg, Germany
| | - Maximilian Herbst
- Science and Research, Physio Meets Science GmbH, Leimen, Baden-Württemberg, Germany
| | | | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Daniel L Belavy
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit, Bochum, North Rhine-Westphalia, Germany
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Oh J, Ripic Z, Signorile JF, Andersen MS, Kuenze C, Letter M, Best TM, Eltoukhy M. Monitoring joint mechanics in anterior cruciate ligament reconstruction using depth sensor-driven musculoskeletal modeling and statistical parametric mapping. Med Eng Phys 2022; 103:103796. [DOI: 10.1016/j.medengphy.2022.103796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/04/2022] [Accepted: 04/05/2022] [Indexed: 11/28/2022]
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Augmentation of Anterolateral Structures of the Knee Causes Undesirable Tibiofemoral Cartilage Contact in Double-Bundle Anterior Cruciate Ligament Reconstruction-A Randomized In-Vivo Biomechanics Study. Arthroscopy 2022; 38:1224-1236. [PMID: 34509591 DOI: 10.1016/j.arthro.2021.08.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To analyze the in vivo tibiofemoral cartilage contact patterns in knees undergoing double-bundle anterior cruciate ligament reconstruction(DB-ACLR) with or without anterolateral structure augmentation (ALSA). METHODS Twenty patients with an ACL-ruptured knee and a healthy contralateral side were included. Nine patients received an isolated DB-ACLR (DB-ACLR group), and 11 patients had a DB-ACLR with ALSA (DB+ALSA group). At 1-year follow-up, a combined computed tomography, magnetic resonance imaging, and dual fluoroscopy imaging system analysis was used to capture a single-legged lunge of both the operated and healthy contralateral side. Tibiofemoral contact points (CPs) of the medial and lateral compartments were compared. CP locations were expressed as anteroposterior (AP, +/-) and medial-lateral (ML, -/+) values according to the tibia. RESULTS In the DB-ACLR knees, no significant differences were found in CPs when compared with the healthy contralateral knees (P ≥ .31). However, in the DB+ALSA knees, the CPs in the lateral compartment had a significantly more anterior (mean AP: operative, -2.8 mm, 95% confidence interval [CI] -5.0 to-0.7 vs healthy, -5.0 mm, 95% CI -6.7 to -3.2; P = .006) and lateral (mean ML: operative, 23.2 mm, 95% CI 21.9-24.5 vs healthy, 21.8 mm, 95% CI 20.2-23.3; P = .013) location. The CPs in the medial compartment were located significantly more posterior (mean AP: operative, -3.4, 95% CI -5.0 to -1.9 vs healthy, -1.3, 95% CI -2.6 to -0.1; P = .006) and lateral (mean ML: operative, -21.3, 95% CI -22.6 to -20.0 vs healthy, -22.6, 95% CI -24.2 to -21.0; P = .021). CONCLUSIONS DB-ACLR restored the tibiofemoral cartilage contact mechanics to near-normal values at 1-year follow-up. Adding the ALSA to the DB-ACLR resulted in significantly altered tibiofemoral cartilage contact locations in both the medial and lateral compartments. CLINICAL RELEVANCE In DB-ACLR knees, the addition of an ALSA may be unfavorable as it caused significantly changed arthrokinematics.
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Fischer AG, Erhart-Hledik JC, Asay JL, Andriacchi TP. Intermittent vibrational stimulation enhances mobility during stair navigation in patients with knee pain. Gait Posture 2021; 86:125-131. [PMID: 33721689 DOI: 10.1016/j.gaitpost.2021.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/01/2021] [Accepted: 03/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Reduced quadriceps function and proprioception can cause decreased mobility during stair navigation in patients with knee pain. Patients can benefit from interventions to mitigate pain and restore quadriceps function. Activating the somatosensory system via intermittent vibrational stimulation has the potential to improve stair navigation mobility in patients with knee pain by moderating quadriceps inhibition and enhancing proprioception. RESEARCH QUESTION What are the effects of intermittent vibrational stimulus synchronized to stair ambulation on muscle activity, kinematics, kinetics, and pain using a randomized controlled clinical trial design. METHODS Thirty-eight patients with knee pain were enrolled into a blinded cross-over study, and twenty-nine patients completed all assessments and analyses. Subjects were randomly assigned sequentially to both an active Treatment A (active) and passive Treatment B (passive) worn at the knee during ambulation for 4 weeks with a 2-week washout period between treatments. RESULTS Knee pain during stair navigation was significantly reduced only with Treatment A (P = 0.007). During ascent, Treatment A (active) significantly increased vastus lateralis activation (P = 0.01), increased knee flexion moment (P = 0.04) and decreased trunk flexion angles (P = 0.015) between baseline and 4-week follow-up. After using passive Treatment B, there were no significant differences in pain (P = 0.19), knee flexion moment (P = 0.09), and trunk flexion angles (P = 0.23). Changes in muscle function correlated significantly with changes in knee flexion moment and trunk flexion with Treatment A (P < 0.015). Descending differed from ascending in response to Treatment A with significantly decreased knee flexion moment(P = 0.04), hip(P = 0.02) and ankle(P = 0.04) flexion angles. Treatment B significantly reduced hip flexion angles (P = 0.005) but not knee flexion moment (P = 0.85). SIGNIFICANCE The results of this study suggest that intermittent vibration can improve joint motion and loading during stair navigation by enhancing quadriceps function during stair ascent and improving movement control during stair descent by modifying an adaptive flexed movement pattern in the lower limb.
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Affiliation(s)
- Arielle G Fischer
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel; Department of Mechanical Engineering, Stanford University, Stanford, CA, United States.
| | - Jennifer C Erhart-Hledik
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, United States; Palo Alto Veterans Hospital, Palo Alto, CA, United States
| | - Jessica L Asay
- Department of Mechanical Engineering, Stanford University, Stanford, CA, United States; Palo Alto Veterans Hospital, Palo Alto, CA, United States
| | - Thomas P Andriacchi
- Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
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Telfer S, Calhoun J, Bigham JJ, Mand S, Gellert JM, Hagen MS, Kweon CY, Gee AO. Biomechanical Effects of Blood Flow Restriction Training after ACL Reconstruction. Med Sci Sports Exerc 2021; 53:115-123. [PMID: 32694365 PMCID: PMC8191295 DOI: 10.1249/mss.0000000000002437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION After anterior cruciate ligament reconstruction surgery, returning the knee to previous levels of strength and function is challenging, with the failure to do so associated with an increased risk of reinjury and long-term degenerative problems. Blood flow restriction (BFR) is gaining popularity as a rehabilitation technique; however, its effects on the mechanics of these exercises have not been fully explored. In this study, we aimed to determine the acute effects of BFR on the performance of a step-up exercise protocol and to assess the acceptability of the technique. METHODS Twenty individuals (12 female/8 male; mean age, 30.6 yr) who had recently undergone anterior cruciate ligament reconstruction and 20 controls (11 female/9 male, mean age 28.0 yr) performed a step-up exercise protocol with and without BFR. Lower limb kinematics and kinetics were measured and compared between groups and conditions. Testing was completed in June 2019. RESULTS Participants in both groups had increased external rotation of the tibia of 2° (P < 0.001) and reductions in knee flexion and rotation torques around the joint of around 50% (P < 0.001) when using BFR compared with nonrestricted step-up exercise. The intervention was found to increase the difficulty of the exercise and induce moderate levels of discomfort (P < 0.001). CONCLUSION The present study provides cautious support for the use of BFR, showing that there are minimal changes in knee joint mechanics when performing the same exercise without BFR, and that the changes do not increase joint torques at the knee. From an acute biomechanical perspective, the intervention appears safe to use under qualified supervision; however, effects of repetitive use and long-term outcomes should be monitored.
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Affiliation(s)
- Scott Telfer
- Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, WA
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Hajizadeh M, Desmyttere G, Carmona JP, Bleau J, Begon M. Can foot orthoses impose different gait features based on geometrical design in healthy subjects? A systematic review and meta-analysis. Foot (Edinb) 2020; 42:101646. [PMID: 32045719 DOI: 10.1016/j.foot.2019.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/01/2019] [Accepted: 10/09/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Foot orthoses (FOs) are popular treatment to alleviate several abnormalities of lower extremity. FO designs might alter lower extremity biomechanics differently, but the association is not yet known. This review aimed to evaluate how different FO designs, namely FO with medial posting, lateral posting, arch support, or arch & heel support, change lower limb kinematics and kinetics during walking. LITERATURE SURVEY Electronic database search were conducted from inception to March 2019, and 25 papers passed the inclusion criteria. Two independent reviewers checked the quality using a modified Downs and Black checklist (73.7±5.5%) and a biomechanical quality checklist (71.4±17.1%). Effect sizes for differences between with- and without- FO walking were calculated, and meta-analysis was performed whenever at least two studies reported the same variable. RESULTS Medial posting reduced peak ankle eversion moment. Lateral posting brought about higher peak ankle dorsiflexion and peak ankle eversion for kinematics, as well as higher peak ankle abduction moment, lower peak knee adduction moment, and higher peak mediolateral ground reaction force (GRF) for kinetics. FOs with either arch support or arch & heel support tended to decrease vertical ground reaction force, but it was not significant. CONCLUSION The findings of this review reveal that medial or lateral posting work efficiently to change foot and knee kinematics and kinetics. However, the impact force is just slightly decreased by arch-supported and heel supported FOs. Due to the small number of available studies, and heterogeneity in meta-analysis findings, further research with more standardized biomechanical approach are required.
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Affiliation(s)
- Maryam Hajizadeh
- Laboratoire de Simulation et Modélisation du Mouvement, Institut Génie Biomédical, Faculté de médecine, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada.
| | - Gauthier Desmyttere
- Laboratoire de Simulation et Modélisation du Mouvement, Département de Kinésiologie, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada
| | | | - Jacinte Bleau
- Laboratoire Orthopédique Médicus, 5135 10(e) avenue, Montréal, QC H1Y 2G5, Canada
| | - Mickael Begon
- Laboratoire de Simulation et Modélisation du Mouvement, Institut Génie Biomédical, Faculté de médecine, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada; Laboratoire de Simulation et Modélisation du Mouvement, Département de Kinésiologie, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada
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Lisee C, Birchmeier T, Yan A, Kuenze C. Associations between isometric quadriceps strength characteristics, knee flexion angles, and knee extension moments during single leg step down and landing tasks after anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon) 2019; 70:231-236. [PMID: 31669921 DOI: 10.1016/j.clinbiomech.2019.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/31/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND It is unclear of how peak knee extension torque and early rate of torque development outcomes are related to lower extremity loading and sagittal plane movement in activities of daily living and landing tasks despite consistent deficits after anterior cruciate ligament reconstruction. The purpose of this cross-section study is to assess the ability of quadriceps strength characteristics to predict movement patterns during a step down and single leg drop crossover hopping tasks. METHODS Fifty-two individuals with a unilateral history of anterior cruciate ligament reconstruction completed three trials of the step down and crossover hopping tasks on their involved limb. Participants completed three isometric knee extension contractions at 90° knee flexion with visual feedback to assess peak knee extension torque and rate of torque development during the first 0-100 ms and 100-200 ms of the contraction. FINDINGS Peak knee extension torque explained the greatest variance in peak knee extension moment (R2 = 40.4%, p < 0.001) and knee flexion angle (R2 = 46.7%, p < 0.001) during the crossover hop landing. Rate of torque development (0-100 ms) was the only predictor of knee flexion angle (R2 = 19.8%, p = 0.01) at initial contact during the crossover hopping landing. Rate of torque development (100-200 ms) explained 17.6% of the variance in peak knee extension moment during the step down (p = .03). INTERPRETATION Peak knee extension torque and early rate of torque development outcomes demonstrate limited relationships between movement of activities of daily living and sport-specific tasks. These limitations should be considered when interpreting the results of isometric strength testing in a clinical setting.
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Affiliation(s)
- Caroline Lisee
- Michigan State University, Department of Kinesiology, College of Education, East Lansing, MI, USA.
| | - Thomas Birchmeier
- Michigan State University, Department of Kinesiology, College of Education, East Lansing, MI, USA
| | - Arthur Yan
- Michigan State University, Division of Sports Medicine, College of Osteopathic Medicine, East Lansing, MI, USA
| | - Christopher Kuenze
- Michigan State University, Department of Kinesiology, College of Education, East Lansing, MI, USA; Michigan State University, Division of Sports Medicine, College of Osteopathic Medicine, East Lansing, MI, USA
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Busch A, Blasimann A, Henle P, Baur H. Neuromuscular activity during stair descent in ACL reconstructed patients: A pilot study. Knee 2019; 26:310-316. [PMID: 30733114 DOI: 10.1016/j.knee.2018.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/20/2018] [Accepted: 12/21/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The anterior cruciate ligament (ACL) rupture is a severe knee injury. Altered kinematics and kinetics in ACL reconstructed (ACL-R) patients compared to healthy participants (ACL-I) are known and attributed to an altered sensorimotor control. However, studies on neuromuscular control often lack homogeneous patient cohorts. The objective was to examine neuromuscular activity during stair descent in patients one year after ACL reconstruction. METHOD Neuromuscular activity of vastus medialis (VM) and lateralis (VL), biceps femoris (BF) and semitendinosus (ST) was recorded by electromyography in 10 ACL-R (age: 26 ± 10 years; height: 175 ± 6 cm; mass: 75 ± 14 kg) and 10 healthy matched controls (age: 31 ± 7 years; height: 175 ± 7 cm; mass: 68 ± 10 kg). A 10-minute walking treadmill warm-up was used for submaximal normalization. Afterwards participants descended 10 times a six-step stairway at a self-selected speed. The movement was separated into pre-activation (PRE), weight acceptance (WA) and push-off phase (PO). Normalized root mean squares for each muscle, limb and movement phase were calculated. Kruskal-Wallis ANOVA compared ACL-R injured and contralateral leg and the ACL-I leg (α = 0.05). RESULTS Significant increased normalised activity in ST during WA in ACL-R injured leg compared to ACL-I and during PO in VL in the ACL-R contralateral leg compared to ACL-I. Decreased activity was shown in VM in ACL-R injured compared to contralateral leg (p < 0.05). CONCLUSION Altered neuromuscular activations are present one year after ACL reconstruction compared to the contralateral and healthy matched control limb. Current standard rehabilitation programs may not be able to fully restore sensorimotor control and demand further investigations.
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Affiliation(s)
- Aglaja Busch
- Department Health & Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, CH-3008 Bern, Switzerland; University Outpatient Clinic, Sports Medicine & Sports Orthopedics, University of Potsdam, Am Neuen Palais 10, DE-14469 Potsdam, Germany.
| | - Angela Blasimann
- Department Health & Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, CH-3008 Bern, Switzerland.
| | - Philipp Henle
- Department of Knee Surgery and Sports Traumatology, Sonnenhof Orthopaedic Center, Buchserstrasse 30, CH-3006 Bern, Switzerland.
| | - Heiner Baur
- Department Health & Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, CH-3008 Bern, Switzerland.
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12
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Desmyttere G, Hajizadeh M, Bleau J, Begon M. Effect of foot orthosis design on lower limb joint kinematics and kinetics during walking in flexible pes planovalgus: A systematic review and meta-analysis. Clin Biomech (Bristol, Avon) 2018; 59:117-129. [PMID: 30227277 DOI: 10.1016/j.clinbiomech.2018.09.018] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/15/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Foot orthoses are commonly used for the management of excessive foot pronation in people with pes planovalgus. However, results are inconsistent due to variability in orthosis geometrical designs. This systematic review with meta-analysis aimed to classify and investigate the effects of foot orthoses, based on their design, in terms of lower limb kinematics and kinetics in people with pes planovalgus. METHODS Electronic databases were searched up until August 2017. Peer-reviewed journal studies including adult participants with flexible pes planovalgus and reporting kinematics and kinetics effects of foot orthoses during walking were included and classified based on the orthosis design. Eleven studies were retained and assessed according to methodological (mean 76.1%; range [63.2%-84.2%] - high) and biomechanical (mean 71.6%; range [44.4%-100%] - moderate) qualities. Meta-analysis was performed by calculating the effect size, using standardized mean differences, between control and orthotics conditions. FINDINGS Meta-analysis revealed less rearfoot eversion with the use of foot orthoses including medial forefoot or both forefoot and rearfoot posting. However, no significant effect of foot orthoses with arch support and neutral rearfoot posting to control excessive foot pronation were found. In terms of kinetics, none of the foot orthoses showed effects. INTERPRETATION Using medial posting is the most effective foot orthotic feature to reduce the peak rearfoot eversion and to control excessive foot pronation. Nevertheless, heterogeneity between study protocols contributes to the low evidences of foot orthoses effects on kinematics and kinetics during walking in people with pes planovalgus.
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Affiliation(s)
- Gauthier Desmyttere
- École de Kinésiologie et des Sciences de l'Activité Physique, Faculté de Médecine, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval H7N 0B6, QC, Canada.
| | - Maryam Hajizadeh
- Institut de Génie Biomédical, Faculté de Médecine, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval H7N 0B6, QC, Canada
| | - Jacinte Bleau
- Laboratoire Orthopédique Médicus, 5135 10e avenue, Montréal H1Y 2G5, QC, Canada
| | - Mickael Begon
- École de Kinésiologie et des Sciences de l'Activité Physique, Faculté de Médecine, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval H7N 0B6, QC, Canada; Institut de Génie Biomédical, Faculté de Médecine, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval H7N 0B6, QC, Canada
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13
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Zhang L, Qi J, Zeng Y, Zhang S, Fu S, Zhou X, Ping R, Li Y. Proprioceptive Changes in Bilateral Knee Joints Following Unilateral Anterior Cruciate Ligament Injury in Cynomolgus Monkeys. Med Sci Monit 2018; 24:105-113. [PMID: 29305572 PMCID: PMC5767072 DOI: 10.12659/msm.905160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/16/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The anterior cruciate ligament (ACL) is one of the most important structures maintaining stability of knee joints, and the proprioception of the ACL plays a key role in it. If the ACL is injured in the unilateral knee joint, it changes nerve electrophysiology, morphology, and quantity of the proprioceptors in the bilateral ACL. The aim of this study was to explore the proprioceptive changes in the bilateral knee joints following unilateral ACL injury, and to provide a theoretical foundation and ideas for clinical treatment. MATERIAL AND METHODS Nine normal cynomolgus monkeys were chosen and used to developed a model of unilateral ACL injury, and 3 monkeys without modeling were used as blank control. At the 4th, 8th, and 12th weeks, the changes in ACL nerves were inspected using electrophysiology [somatosensory evoked potentials (SEPs) and motor nerve conduction velocity (MCV)], and the changes of morphology and quantity of the proprioceptors in ACL were observed and measured under gold chloride staining. RESULTS On the injured and contralateral knee joints, the incubations were extended and the amplitudes were decreased over time. In addition, with the extension of time, the total number of proprioceptors in the ACL decreased, and the variable number of proprioceptors in the ACL increased. CONCLUSIONS ACL injury leads to attenuation of proprioception on the injured side, and also leads to the attenuation of proprioception on the contralateral side, and there is a tendency could get worse over time.
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Affiliation(s)
- Lei Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Ji Qi
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Yan Zeng
- Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
| | - Shaoqun Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Shijie Fu
- Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
| | - Xin Zhou
- Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
| | - Ruiyue Ping
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yikai Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, P.R. China
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14
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Sole G, Pataky T, Tengman E, Häger C. Analysis of three-dimensional knee kinematics during stair descent two decades post-ACL rupture - Data revisited using statistical parametric mapping. J Electromyogr Kinesiol 2016; 32:44-50. [PMID: 28039768 DOI: 10.1016/j.jelekin.2016.12.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/22/2016] [Accepted: 12/15/2016] [Indexed: 12/11/2022] Open
Abstract
Changes in movement patterns following knee injuries have generally used analyses of pre-defined discrete event-related variables, whereas Statistical Parametric Mapping (SPM) assesses continuous data over time. We applied SPM to test differences for knee trajectories during stair descent between participants with past anterior cruciate ligament (ACL) rupture who underwent reconstruction or only physical therapy compared to healthy controls. Three-dimensional knee joint kinematics during stair descent were registered for 31 subjects with ACL reconstruction (ACLR), 36 subjects with ACL rupture managed with physical therapy only (ACLPT) (∼23years post-injury), and 32 uninjured controls. SPM was used to assess differences between groups for the entire three-component knee trajectory. A significant difference between the three groups was found for the first ∼10% of stance phase. Post-hoc analyses showed between-group differences when comparing the ACLPT to the control groups. Analyses of ACLPT versus control groups for individual vector components suggested a combination of less flexion at initial foot contact, and less adduction during weight acceptance (∼40% of stance). Altered knee kinematics were confirmed during weight acceptance of stair descent for the ACLPT group compared to controls, but not for ACLR group. Further exploration of the use of SPM and agreement with clinical gait assessment is warranted.
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Affiliation(s)
- Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Box 56, Dunedin 9056, New Zealand.
| | - Todd Pataky
- Institute of Fiber Engineering, Department of Bioengineering, Shinshu University, Tokida 3-15-1, Ueda, Nagano 386-8567, Japan.
| | - Eva Tengman
- Institute of Fiber Engineering, Department of Bioengineering, Shinshu University, Tokida 3-15-1, Ueda, Nagano 386-8567, Japan.
| | - Charlotte Häger
- Dept. of Community Medicine and Rehabilitation, Section for Physical Therapy, Umeå University, SE-90187 Umeå, Sweden.
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