1
|
Si B, Zhu H, Wei X, Li S, Wu X. The mechanism of static postural control in the impact of lower limb muscle strength asymmetry on gait performance in the elderly. PeerJ 2024; 12:e17626. [PMID: 38948226 PMCID: PMC11214735 DOI: 10.7717/peerj.17626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 06/02/2024] [Indexed: 07/02/2024] Open
Abstract
Background Abnormal gait is prevalent among the elderly population, leading to reduced physical activity, increased risk of falls, and the potential development of dementia and disabilities, thus degrading the quality of life in later years. Numerous studies have highlighted the crucial roles of lower limb muscle strength asymmetry and static postural control in gait, and the reciprocal influence of lower limb muscle strength asymmetry on static postural control. However, research exploring the interrelationship between lower limb muscle strength asymmetry, static postural control, and gait performance has been limited. Methods A total of 55 elderly participants aged 60 to 75 years were recruited. Isokinetic muscle strength testing was used to assess bilateral knee extension strength, and asymmetry values were calculated. Participants with asymmetry greater than 15% were categorized as the Asymmetry Group (AG), while those with asymmetry less than 15% were classified in the Symmetry Group (SG). Gait parameters were measured using a plantar pressure gait analysis system to evaluate gait performance, and static postural control was assessed through comfortable and narrow stance tests. Results First, participants in the AG demonstrated inferior gait performance, characterized by slower gait speed, longer stance time and percentage of stance time in gait, and smaller swing time and percentage of swing time in gait. Spatial-temporal gait parameters of the weaker limb tended to be abnormal. Second, static postural control indices were higher in AG compared to SG in all aspects except for the area of ellipse during the comfortable stance with eyes open test. Third, abnormal gait parameters were associated with static postural control. Conclusion Firstly, elderly individuals with lower limb muscle strength asymmetry are prone to abnormal gait, with the weaker limb exhibiting poorer gait performance. Secondly, lower limb muscle strength asymmetry contributes to diminished static postural control in the elderly. Thirdly, the mechanism underlying abnormal gait in the elderly due to lower limb muscle strength asymmetry may be linked to a decline in static postural control.
Collapse
Affiliation(s)
- Beili Si
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Hao Zhu
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Xinmei Wei
- School of Economics and Management, Shanghai University of Sport, Shanghai, China
| | - Shun Li
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Xueping Wu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
2
|
Toriyama M, Nakamae A, Abe T, Hirata K, Adachi N. Dependence on visual information in patients with ACL injury for multi-joint coordination during single-leg squats: a case control study. BMC Sports Sci Med Rehabil 2024; 16:87. [PMID: 38632628 PMCID: PMC11022393 DOI: 10.1186/s13102-024-00875-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The influence of vision on multi-joint control during dynamic tasks in anterior cruciate ligament (ACL) deficient patients is unknown. Thus, the purpose of this study was to establish a new method for quantifying neuromuscular control by focusing on the variability of multi-joint movement under conditions with different visual information and to determine the cutoff for potential biomarkers of injury risk in ACL deficient individuals. METHODS Twenty-three ACL deficient patients and 23 healthy subjects participated in this study. They performed single-leg squats under two different conditions: open eyes (OE) and closed eyes (CE). Multi-joint coordination was calculated with the coupling angle of hip flexion, hip abduction and knee flexion. Non-linear analyses were performed on the coupling angle. Dependence on vision was compared between groups by calculating the CE/OE index for each variable. Cutoff values were calculated using ROC curves with ACL injury as the dependent variable and significant variables as independent variables. RESULTS The sample entropy of the coupling angle was increased in all groups under the CE condition (P < 0.001). The CE/OE index of coupling angle variability during the descending phase was higher in ACL deficient limbs than in the limbs of healthy participants (P = 0.036). The CE/OE index of sample entropy was higher in the uninjured limbs of ACL deficient patients than in the limbs of healthy participants (P = 0.027). The cutoff value of the CE/OE index of sample entropy was calculated to be 1.477 (Sensitivity 0.957, specificity 0.478). CONCLUSION ACL deficient patients depended on vision to control multiple joint movements not only on the ACL deficient side but also on the uninjured side during single leg squat task. These findings underscore the importance of considering visual dependence in the assessment and rehabilitation of neuromuscular control in ACL deficient individuals.
Collapse
Affiliation(s)
- Minoru Toriyama
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Hiroshima, Japan
- Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Handa, Aichi, Japan
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Atsuo Nakamae
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Hiroshima, Japan.
| | - Takumi Abe
- Department of Rehabilitation, Hiroshima Hiramatsu Hospital, Hiroshima, Hiroshima, Japan
| | - Kazuhiko Hirata
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Hiroshima, Japan
- Department of Rehabilitation, Division of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Hiroshima, Japan
| |
Collapse
|
3
|
Rodrigues R, Gonçalves V, Casagrande R, Cemin F, Nodari C, Borges I, Fitarelli L, Bianchesse J, Rocha ESD, Rabello R. Are proximal and distal neuromuscular parameters able to predict hip and knee frontal plane kinematics during single-leg landing? Phys Ther Sport 2023; 59:30-36. [PMID: 36481454 DOI: 10.1016/j.ptsp.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To determine if proximal and distal neuromuscular parameters (EMG amplitude and median frequency - MDF) can predict frontal plane kinematics during single-leg landing. STUDY DESIGN Cross sectional study. SETTING Laboratory. PARTICIPANTS Fifteen participants (7 female) performed six single-leg landings with measures of frontal plane kinematics and EMG obtained 230 ms after first foot contact, totalizing 90 landings. MAIN OUTCOME MEASURES (i) 2D hip adduction [hip ADD] and knee frontal plane projection angle [knee FPPA]; (ii) EMG amplitude and MDF of gluteus medius [GMed], tensor fascia latae [TFL], peroneus longus [PL] and tibialis anterior [TA]. RESULTS We observed that MDF of TA was a significant predictor of hip ADD (p = 0.037; β = -0.049 Hz; R2c = 0.30). Also, MDF of PL was significant predictor of knee FPPA (p = 0.043; β = 0.042 Hz; R2c = 0.37). Hip muscles and EMG amplitude parameters were not considered predictors of frontal plane kinematics. CONCLUSION The firing frequency of ankle muscles predicted the variance of hip and knee frontal plane kinematics during single-leg landing.
Collapse
Affiliation(s)
- Rodrigo Rodrigues
- Institute of Education, Federal University of Rio Grande, Rio Grande, RS, Brazil.
| | - Vagner Gonçalves
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Rafael Casagrande
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Fabrício Cemin
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Camila Nodari
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Iury Borges
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Luan Fitarelli
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Jean Bianchesse
- Exercise Physiology and Physical Assessment Laboratory, Serra Gaucha University Center, Caxias do Sul, RS, Brazil
| | - Emmanuel Souza da Rocha
- Department of Physical Therapy, Integrated Colleges of Taquara, Taquara, RS, Brazil; Physical Activity, Sport and Health Research Group, Department of Physical Therapy, Sogipa Faculty, Porto Alegre, RS, Brazil
| | - Rodrigo Rabello
- Department of Biomedical Sciences for Health, University of Milan, Milan, MI, Italy
| |
Collapse
|
4
|
Importance of Lower Extremity Muscle Performance and Knee Proprioception During First 60 Degrees of Knee Flexion at Three Months After Anterior Cruciate Ligament Reconstruction. Asian J Sports Med 2022. [DOI: 10.5812/asjsm-120211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Knee proprioception and neuromuscular control may be important factors contributing to re-injury occurrences. Objectives: To examine lower extremity muscular performance and knee proprioception preoperatively and 3 months after anterior cruciate ligament (ACL) reconstruction. Methods: Twelve participants underwent ACL reconstruction using the hamstring tendon. All participants were assessed for knee proprioceptive sense using an isokinetic dynamometer at 15° and 60° of knee flexion. Lower extremity muscular performance was examined using the single-leg squat test (SLS) with two-dimensional motion analysis in frontal and sagittal planes. Results: Mean absolute error angle at a 15-degree-target angle was significantly lower at three months after ACL reconstruction compared with the preoperative state (P = 0.04). Maximal knee flexion angle of the injured The SLS test showed a lesser knee flexion angle of the injured knee at three months after ACL reconstruction (P = 0.01), and injured knee proprioception at 60 degree-flexion did not significantly improve at the three month-postoperative stage. Conclusions: At three months after ACL reconstruction by hamstring graft tendon, knee proprioceptive sense at an inner range of knee extension improved. However, proprioception at the middle range did not significantly develop. The range of hip and knee motions using SLS related to strength changes that the knee extensor needs to improve, especially in the middle range.
Collapse
|
5
|
Blasimann A, Busch A, Henle P, Bruhn S, Vissers D, Baur H. Neuromuscular Control During Stair Descent and Artificial Tibial Translation After Acute ACL Rupture. Orthop J Sports Med 2022; 10:23259671221123299. [PMID: 36263309 PMCID: PMC9575465 DOI: 10.1177/23259671221123299] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/05/2022] [Indexed: 11/07/2022] Open
Abstract
Background: Anterior cruciate ligament (ACL) rupture has direct effect on passive and
active knee stability and, specifically, stretch-reflex excitability. Purpose/Hypothesis: The purpose of this study was to investigate neuromuscular activity in
patients with an acute ACL deficit (ACL-D group) compared with a matched
control group with an intact ACL (ACL-I group) during stair descent and
artificially induced anterior tibial translation. It was hypothesized that
neuromuscular control would be impaired in the ACL-D group. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Surface electromyographic (EMG) activity of the vastus medialis (VM), vastus
lateralis (VL), biceps femoris (BF), and semitendinosus (ST) muscles was
recorded bilaterally in 15 patients with ACL-D (mean, 13.8 days [range, 7-21
days] since injury) and 15 controls with ACL-I during stair descent and
artificially induced anterior tibial translation. The movements of stair
descent were divided into preactivity, weight acceptance, and push-off
phases. Reflex activity during anterior tibial translation was split into
preactivity and short, medium, and late latency responses. Walking on a
treadmill was used for submaximal EMG normalization. Kruskal-Wallis test and
post hoc analyses with Dunn-Bonferroni correction were used to compare
normalized root mean square values for each muscle, limb, movement, and
reflex phase between the ACL-D and ACL-I groups. Results: During the preactivity phase of stair descent, the hamstrings of the involved
leg of the ACL-D group showed 33% to 51% less activity compared with the
matched leg and contralateral leg of the ACL-I group (P
< .05). During the weight acceptance and push-off phases, the VL revealed
a significant reduction (approximately 40%) in the involved leg of the ACL-D
group compared with the ACL-I group. At short latency, the BF and ST of the
involved leg of the ACL-D group showed a significant increase in EMG
activity compared with the uninvolved leg of the ACL-I group, by a factor of
2.2 to 4.6. Conclusion: In the acute phase after an ACL rupture, neuromuscular alterations were found
mainly in the hamstrings of both limbs during stair descent and reflex
activity. The potential role of prehabilitation needs to be further
studied.
Collapse
Affiliation(s)
- Angela Blasimann
- Division of Physiotherapy, Department of Health Professions, Bern
University of Applied Sciences, Bern, Switzerland.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of
Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.,Angela Blasimann, MSc, Department of Health Professions, Bern
University of Applied Sciences, Murtenstrasse 10, CH-3008 Bern, Switzerland
()
| | - Aglaja Busch
- Division of Physiotherapy, Department of Health Professions, Bern
University of Applied Sciences, Bern, Switzerland.,University Outpatient Clinic, Sports Medicine & Sports
Orthopedics, University of Potsdam, Potsdam, Germany
| | - Philipp Henle
- Sonnenhof Orthopaedic Center, Lindenhof Group AG, Bern,
Switzerland.,Department of Orthopaedic Surgery and Traumatology, Inselspital,
Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sven Bruhn
- Institute of Sports Science, University of Rostock, Rostock,
Germany
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of
Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Heiner Baur
- Division of Physiotherapy, Department of Health Professions, Bern
University of Applied Sciences, Bern, Switzerland
| |
Collapse
|
6
|
The role of hip abductor strength and ankle dorsiflexion range of motion on proximal, local and distal muscle activation during single-leg squat in patellofemoral pain women: an all-encompassing lower limb approach. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00980-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
7
|
Keller M, Diemer F, Kurz E. [Judging movement quality in patients who sustained a knee ligament injury: a systematic review]. SPORTVERLETZUNG-SPORTSCHADEN 2022; 36:38-48. [PMID: 34983071 DOI: 10.1055/a-1551-4388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Knee joint injury statistics are dominated by ruptures of the capsular ligament structures. Post-traumatic deficits in dynamic movement patterns are assessed quantitatively as well as qualitatively. The aim of this review was to compile tools that are used to assess the quality of movement after knee ligament injuries in adults. METHODS A systematic search for original papers was carried out in the following primary sources: Ovid, PubMed, Scopus and Web of Science. Both conservative and surgical treatment options were considered. PROSPERO registration of the study protocol: CRD42020175359. RESULTS A total of 1153 papers were identified. Eleven original papers from four different working groups were included in this work. All papers assessed the quality of movement in adults after anterior cruciate ligament (ACL) injury. A total of 348 (70 deficient, 278 reconstructed) patients after an ACL injury and 119 adults with an intact ACL were examined in the studies included. CONCLUSION It is possible to assess movement quality after a knee ligament injury with a low temporal and technical effort. The changes recorded result in a functional valgus, which, based on the study results, may be further differentiated into isolated knee valgus, medial collapse or postural collapse.
Collapse
Affiliation(s)
| | - Frank Diemer
- DIGOTOR GbR, Fortbildungen für Orthopädische Medizin und Manuelle Therapie, Brackenheim, Germany
| | - Eduard Kurz
- OSINSTITUT ortho & sport, München, Germany.,Universitätsklinikum Halle, Halle (Saale), Germany
| |
Collapse
|
8
|
Guiotto A, Ciniglio A, Spolaor F, Pavan D, Cibin F, Scaldaferro A, Sawacha Z. Reliability and Repeatability of ACL Quick Check ®: A Methodology for on Field Lower Limb Joint Kinematics and Kinetics Assessment in Sport Applications. SENSORS 2021; 22:s22010259. [PMID: 35009800 PMCID: PMC8749888 DOI: 10.3390/s22010259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/18/2021] [Accepted: 12/26/2021] [Indexed: 01/29/2023]
Abstract
Anterior cruciate ligament (ACL) lesion represents one of the most dramatic sport injuries. Even though clinical screenings aiming at identifying subjects at risk of injuries are gaining popularity, the use of sophisticated equipment still represents a barrier towards their widespread use. This study aimed to test both reliability and repeatability of a new methodology to assess lower limb joints kinematics and kinetics directly on field with the aid of video cameras and plantar pressure insoles. Ten athletes and one case study (post ACL surgery) were assessed in a gait laboratory, while performing double leg squats, through the simultaneous acquisition of stereophotogrammetry, force plates, commercial video cameras and plantar pressure insoles. Different sources of errors were investigated and both reliability and repeatability analysis performed. Minimum and maximum RMSE values of 0.74% (right knee joint center trajectory) and 64.51%, respectively (ankle dorsi-plantarflexion moment), were detected. Excellent to good correlation was found for the majority of the measures, even though very poor and inverse between-trials correlation was found on a restricted number of trials especially for the ankle dorsi-plantarflexion moment. These findings could be used in combination with already available screening tools in order to provide more repeatable results.
Collapse
|
9
|
Batty LM, Feller JA, Damasena I, Behrens G, Devitt BM, Hartwig T, McClelland JA, Webster KE. Single-Leg Squat After Anterior Cruciate Ligament Reconstruction: An Analysis of the Knee Valgus Angle at 6 and 12 Months. Orthop J Sports Med 2020; 8:2325967120946328. [PMID: 32923508 PMCID: PMC7453457 DOI: 10.1177/2325967120946328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 03/31/2020] [Indexed: 01/14/2023] Open
Abstract
Background: Deficits in neuromuscular control are common after anterior cruciate ligament (ACL) reconstruction and may be associated with further knee injury. The knee valgus angle during a single-leg squat (SLS) is one measure of neuromuscular performance. Purpose: To determine whether the knee valgus angle during SLS changes between 6 and 12 months after ACL reconstruction and to assess how the operative knee valgus angle compares with that of the contralateral side. Study Design: Case series; Level of evidence, 4. Methods: A cohort of 100 patients with uninjured contralateral knees were assessed at 6 and 12 months after primary hamstring autograft ACL reconstruction. Participants performed the SLS on each leg, and the knee valgus angle was measured via frame-by-frame video analysis at 30° of flexion and at each patient’s maximum knee flexion angle. Results: For the operative limb at 30° of flexion, a small but statistically significant reduction was noted in the valgus angle between 6 and 12 months (5.46° vs 4.44°; P = .002; effect size = 0.24). At 6 months, a slightly higher valgus angle was seen in the operative limb compared with the nonoperative limb (5.46° vs 4.29°; P = .008; effect size = 0.27). At maximum flexion, no difference was seen between limbs in the valgus angle at either 6 or 12 months, and no change was seen in the operative limb between 6 and 12 months. At 6 months and 30° of knee flexion, 13 patients had a valgus angle greater than 10°. This group also had a higher mean valgus angle in the contralateral limb compared with the contralateral limb in the other 87 patients (8.5° vs 3.65°; P < .001). Conclusion: During a controlled SLS, the knee valgus angle remained essentially constant, and minimal limb asymmetries were present over the 6- to 12-month postoperative period, a time when athletes typically increase their activity levels. Whether changes or asymmetries will be seen with more dynamically challenging tasks remains to be determined. When present, high valgus angles were commonly bilateral.
Collapse
Affiliation(s)
- Lachlan M Batty
- OrthoSport Victoria Research Unit, Melbourne, Victoria, Australia.,St. Vincent's Hospital Melbourne, Victoria, Australia
| | - Julian A Feller
- OrthoSport Victoria Research Unit, Melbourne, Victoria, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Iswadi Damasena
- OrthoSport Victoria Research Unit, Melbourne, Victoria, Australia
| | - Gerrit Behrens
- OrthoSport Victoria Research Unit, Melbourne, Victoria, Australia.,Praxisklinik Rennbahn AG, Muttenz, Switzerland
| | - Brian M Devitt
- OrthoSport Victoria Research Unit, Melbourne, Victoria, Australia
| | - Taylor Hartwig
- OrthoSport Victoria Research Unit, Melbourne, Victoria, Australia
| | - Jodie A McClelland
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Kate E Webster
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
10
|
Forward lunge before and after anterior cruciate ligament reconstruction: Faster movement but unchanged knee joint biomechanics. PLoS One 2020; 15:e0228071. [PMID: 31978123 PMCID: PMC6980669 DOI: 10.1371/journal.pone.0228071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/07/2020] [Indexed: 11/19/2022] Open
Abstract
The forward lunge (FL) may be a promising movement to assess functional outcome after ACL reconstruction. Thus, we aimed to investigate the FL movement pattern before and after ACL reconstruction with a comparison to healthy controls to determine if differences were present. Twenty-eight ACL injured participants and 28 matched healthy controls were included. They performed FL movements while sagittal plane biomechanics of the knee and electromyography (EMG) of nine leg muscles was assessed. The ACL injured group was tested before and 10 months after surgery. The perceived knee function and activity level was assessed by questionnaires. The ACL injured group performed the FL significantly slower than the controls before surgery (mean difference: 0.41 s [95%CI: 0.04-0.79 s; p<0.05]) while they performed the FL as fast as the controls after surgery (~28% movement time reduction post-surgery). Perceived knee function and activity level improved significantly post-surgery. The knee joint flexion angle, extensor moment, power, angular velocity in the ACL injured group did not differ from pre to post-surgery. For the ACL injured group, the peak knee extensor moment observed both pre and post-surgery was significantly lower when compared to the controls. The EMG results showed minimal differences. In conclusion, at 10 months post-surgery, the FL was performed significantly faster and the movement time was comparable to that of the controls. While the perceived knee function and activity level improved post-surgery, the knee joint biomechanics were unchanged. This may reflect that knee joint function was not fully restored.
Collapse
|
11
|
Hip Abductor and Adductor Muscles Activity Patterns During Landing After Anterior Cruciate Ligament Injury. J Sport Rehabil 2019; 28:871-876. [DOI: 10.1123/jsr.2018-0189] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/09/2018] [Accepted: 09/12/2018] [Indexed: 11/18/2022]
Abstract
Context: Hamstring and quadriceps activity adaptations are well known in individuals with anterior cruciate ligament deficiency (ACLD) and reconstructed (ACLR) to potentially compensate for knee joint instability. However, few studies have explored hip muscles activity patterns after ACL injury. Objective: To examine the activation characteristics of gluteus medius (GMED) and adductor longus in ACLR and ACLD subjects compared with controls. Design: Case–control study. Setting: Athletic training room and university lab. Participants: Twelve healthy and 24 ACL-injured (12 ACLR and 12 ACLD) recreationally active male volunteers. Interventions: Surface electromyography of the GMED and adductor longus were recorded during a single-leg vertical drop landing and normalized to maximum voluntary isometric contractions. Main Outcome Measures: Preparatory and reactive muscle activity and coactivation were analyzed from 100 milliseconds prior to initial contact to 250 milliseconds postcontact. Results: During reactive activity, ACL-injured (ACLR and ACLD) participants demonstrated significantly lower peak GMED activity compared with controls (F = 4.33, P = .02). In addition, ACLR participants exhibited significantly lower reactive GMED:adductor longus coactivation muscle activity compared with controls (F = 4.09, P = .03). Conclusion: Our findings suggest neuromuscular adaptations of the hip musculature are present in people at least 2 years from ACL injury. GMED activation exercises should be considered in designing rehabilitation programs for ACL-injured individuals.
Collapse
|
12
|
Single-Leg Squat Delicacies-The Position of the Nonstance Limb is an Important Consideration. J Sport Rehabil 2019; 28:318-324. [PMID: 30426818 DOI: 10.1123/jsr.2018-0181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Context: The single-leg squat task is often used as a rehabilitative exercise or as a screening tool for the functional movement of the lower limb. Objective: To establish the effect of 3 different positions of the nonstance leg on 3-dimensional kinematics, muscle activity, and center of mass displacement during a single-leg squat. Design: Within-subjects, repeated-measures design. Setting: Movement analysis laboratory. Participants: A total of 10 participants, aged 28.2 (4.42) years performed 3 squats to 60° of knee flexion with the nonstance (1) hip at 90° flexion and knee at 90° flexion, (2) hip at 30° flexion with the knee fully extended, or (3) hip in neutral/0° and the knee flexed to 90°. Main Outcome Measures: Trunk, hip, knee and ankle joint angles, and center of mass displacement were recorded with inertial sensors while muscle activity was captured through wireless electromyography. Results: Most trunk flexion (21.38° [18.43°]) occurred with the nonstance hip at 90° and most flexion of the stance hip (23.10° [6.60°]) occurred with the nonstance hip at 0°. Biceps femoris activity in the 90° squat was 40% more than in the 0° squat, whereas rectus femoris activity in the 0° squat was 29% more than in the 90° squat. Conclusion: The position of the nonstance limb should be standardized when the single-leg squat is used for assessment and be adapted to the aim when used in rehabilitation.
Collapse
|
13
|
Frontal plane movement of the pelvis and thorax during dynamic activities in individuals with and without anterior cruciate ligament injury. Knee 2018; 25:997-1008. [PMID: 30172444 PMCID: PMC6291429 DOI: 10.1016/j.knee.2018.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 05/29/2018] [Accepted: 06/04/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND For elite athletes with anterior cruciate ligament (ACL) reconstruction, reducing pelvis and trunk obliquities is a common goal of rehabilitation. It is not known if this is also a suitable goal for the general population. This study aimed to quantify pelvis and thorax obliquities during dynamic activities in individuals from the general population with and without history of ACL injury. METHODS Retrospective analysis of cross-sectional data from 30 participants with ACL reconstruction, 28 participants with ACL deficiency (ACLD), and 32 controls who performed overground walking and jogging, single-leg squat, and single-leg hop for distance. Pelvis and thorax obliquities were quantified in each activity and compared across groups using one-way ANOVA. Coordination was quantified using cross covariance. RESULTS In the stance phase of walking and jogging, pelvis and thorax obliquities were within ±10° of neutral and there was a negative correlation between the two segments at close to zero phase lag. In single-leg squat and hop, range of obliquities varied across individuals and there was no consistent pattern of coordination. Eight ACLD participants felt unable to perform the single-leg hop. In the remaining participants, range of pelvis (p = 0.04) and thorax (p = 0.02) obliquities was smaller in ACLD than controls. CONCLUSIONS In challenging single-leg activities, minimal frontal plane motion was not the typical movement pattern observed in the general population. Coordination between the pelvis and thorax was inconsistent within and across individuals. Care should be taken when considering minimising pelvis and thorax obliquities in patients with ACL injury.
Collapse
|
14
|
Goff AJ, Page WS, Clark NC. Reporting of acute programme variables and exercise descriptors in rehabilitation strength training for tibiofemoral joint soft tissue injury: A systematic review. Phys Ther Sport 2018; 34:227-237. [PMID: 30388671 DOI: 10.1016/j.ptsp.2018.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/17/2018] [Accepted: 10/20/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Strength training acute programme variables (APVs) can impact tibiofemoral joint injury outcomes. Exercise descriptors (EDs; e.g. patient-position) specify configurations within which APVs are applied. Evidence-based practice depends on adequate reporting of APVs and EDs to replicate strength training interventions in clinical practice. This systematic review assessed APV and ED reporting for adults with tibiofemoral joint injury (anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL)/medial collateral ligament (MCL)/lateral collateral ligament (LCL)/meniscus/hyaline cartilage (HC)). METHODS PRISMA guidelines were followed. Specific key-term combinations were employed and database searches performed. Descriptive/observational/experimental studies were included (2006-2018). Studies needed to report pre-defined APVs or EDs for ≥51% of all exercises to be included. Frequency counts were made of studies adequately reporting APVs and EDs. RESULTS Sixteen articles were included (ACL = 13; meniscus = 3). No PCL/MCL/LCL/HC articles were identified. Of nine APVs, five and four were consistently reported by the majority of ACL (≥7) and meniscal (≥2) studies, respectively. Of eight EDs, four were consistently reported by the majority of both ACL (≥8) and meniscal (≥2) studies. CONCLUSION Many APVs and EDs were not adequately reported. Future studies should better document APVs and EDs for higher standards of intervention reporting and enhanced translation of research to clinical practice.
Collapse
Affiliation(s)
- Anthony J Goff
- Health and Social Sciences, Singapore Institute of Technology, 10 Dover Drive, 138683, Singapore.
| | - William S Page
- Faculty of Sport, Health and Applied Sciences, St Mary's University, Waldegrave Road, Twickenham, TW1 4SX, UK.
| | - Nicholas C Clark
- Faculty of Sport, Health and Applied Sciences, St Mary's University, Waldegrave Road, Twickenham, TW1 4SX, UK.
| |
Collapse
|
15
|
Wilson DA, Booysen N, Dainese P, Heller MO, Stokes M, Warner MB. Accuracy of movement quality screening to document effects of neuromuscular control retraining exercises in a young ex-footballer with hip and groin symptoms: A proof of concept case study. Med Hypotheses 2018; 120:116-120. [PMID: 30220329 DOI: 10.1016/j.mehy.2018.08.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/23/2018] [Accepted: 08/30/2018] [Indexed: 11/15/2022]
Abstract
Hip and groin pain is common in footballers and altering movement patterns can reduce symptoms. Observational tests of movement control are thought to identify abnormal movement patterns, but their accuracy needs yet to be confirmed by comparison with an objective measure. To assess the accuracy, using 3D motion analysis, of observational movement control tests and their ability to detect changes, and document changes in symptoms following a neuromuscular control exercise programme in an ex-footballer with hip and groin pain. A 25-year-old male with chronic bilateral hip and groin pain had their movement control ability rated and kinematic data collected using 3D motion analysis while performing Small Knee Bend (SKB) and SKB with Rotation (SKB Rot) tests pre-and post-neuromuscular control exercise training. Movement control was rated as at fault if they were unable to control specific trunk and pelvic movements during the tests. The Copenhagen Hip and Groin Outcome Score (HAGOS) was used to assess symptoms. Following the intervention, observational rating during the SKB test improved from fault to no fault for anterior pelvic tilt, which decreased by 17° and 16° during right and left leg SKB tests respectively. The HAGOS symptoms subsection improved from 36% to 61%. Observational movement screening ratings were supported by 3-D motion analysis. These findings indicate that the screening tool was accurate for detecting improvements in trunk and pelvic movement control following an exercise programme in an ex-footballer who had presented with hip and groin pain.
Collapse
Affiliation(s)
- David A Wilson
- School of Health Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK.
| | - Nadine Booysen
- School of Health Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK
| | - Paolo Dainese
- Department of Medical Science, University of Turin, Italy
| | - Markus O Heller
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK
| | - Maria Stokes
- School of Health Sciences, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK
| | - Martin B Warner
- School of Health Sciences, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK
| |
Collapse
|
16
|
Hip Musculoskeletal Conditions and Associated Factors That Influence Squat Performance: A Systematic Review. J Sport Rehabil 2018; 27:263-273. [PMID: 28290757 DOI: 10.1123/jsr.2016-0246] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
CONTEXT The squat is a fundamental movement for weightlifting and sports performance. Both unilateral and bilateral squats are also used to assess transitional and dynamic lower-extremity control. Common lower-extremity conditions can have an influence on squat performance. Of interest are the effects of hip musculoskeletal conditions and associated factors, such as hip muscle pain, fatigue, and tightness, on squat performance. Currently, there has been no appraisal of the evidence regarding the association of these conditions and associated factors on squat performance. OBJECTIVE This study evaluated the current evidence regarding common hip musculoskeletal conditions and associated factors, such as hip muscle pain, fatigue, and tightness, on squat performance. EVIDENCE ACQUISITION A systematic review was conducted according to preferred reporting items for systematic reviews and meta-analyses guidelines. A search of PubMed, CINAHL, SPORTDiscus, ProQuest, and Google Scholar® was conducted in October, 2016 using the following keywords alone and in combination: hip, joint, arthritis, pain, range of motion (ROM), fatigue, tightness, pathology, condition, muscle, intraarticular, extraarticular, femoroacetabular impingement, single leg, bilateral, squat, performance, and technique. The grading of studies was conducted using the Physiotherapy Evidence Database scale. EVIDENCE SYNTHESIS The authors identified 35 citations, 15 of which met the inclusion criteria. The qualifying studies yielded a total of 542 subjects (160 men and 382 women; mean age = 29.3 (5.9) y) and measured performance with either the barbell squat, step down, bilateral, or single-leg squat. Femoroacetabular impingement and hip arthroscopy were the only hip conditions found that affected the squat. Associated factors, such as muscle pain, fatigue, and tightness, also influenced squat performance. CONCLUSION This review found that common hip conditions and associated factors and their effects on squat performance to be underinvestigated. Future research should focus on the association between common hip conditions and squat performance.
Collapse
|
17
|
Cronström A, Creaby MW, Nae J, Ageberg E. Modifiable Factors Associated with Knee Abduction During Weight-Bearing Activities: A Systematic Review and Meta-Analysis. Sports Med 2018; 46:1647-1662. [PMID: 27048463 DOI: 10.1007/s40279-016-0519-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Increased knee abduction angle during activity is suggested to be a risk factor for sustaining an anterior cruciate ligament (ACL) injury or developing patellofemoral pain syndrome (PFPS). Knowledge of the modifiable mechanisms that are associated with increased knee abduction will aid in the appropriate design of preventive and rehabilitative strategies for these injuries. OBJECTIVE Our objective was to systematically review modifiable mechanisms contributing to increased knee abduction in healthy people and in individuals with an ACL injury or PFPS. METHODS We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the databases MEDLINE, CINAHL, and Embase until September 2015. Inclusion criteria were studies in healthy individuals and/or those with ACL injury or PFPS reporting (1) muscle strength, muscle activation, proprioception, and/or range of motion (ROM) and (2) knee abduction angle assessed with either motion analysis or visual observation during weight-bearing activity. RESULTS In total, 33 articles were included. Reduced trunk strength, reduced gluteus maximus amplitude, decreased ankle ROM, and increased hip external rotation ROM were moderately associated with increased knee abduction angle (r -0.34 or higher, standardized difference in means (SDM) greater than -0.39, p < 0.05, articles n = 3, total sample size n = 101-114) in healthy individuals. Decreased strength of hip abductors, external rotators, and extensors and knee flexors were at most weakly associated with increased knee abduction angle (r ≤ 0.21, p = 0.013-0.426, articles n = 2-9, total sample size n = 80-311). Too few articles included patients with knee injury to be included in any meta-analysis. CONCLUSION The associations identified in this review indicate that investigation of strengthening of the trunk muscles, and improvement of gluteus maximus activation and ankle ROM to change knee kinematics is merited. Studies on modifiable factors associated with increased knee abduction angle in people with knee injury are needed.
Collapse
Affiliation(s)
- Anna Cronström
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden.
| | - Mark W Creaby
- School of Exercise Science, Australian Catholic University, Brisbane, QLD, Australia
| | - Jenny Nae
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden
| | - Eva Ageberg
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden
| |
Collapse
|
18
|
Kolber MJ, Stull KR, Cheatham SW, Hanney WJ. The Influence of Hip Muscle Impairments on Squat Performance. Strength Cond J 2017. [DOI: 10.1519/ssc.0000000000000305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
19
|
Balshaw TG, Fry A, Maden-Wilkinson TM, Kong PW, Folland JP. Reliability of quadriceps surface electromyography measurements is improved by two vs. single site recordings. Eur J Appl Physiol 2017; 117:1085-1094. [PMID: 28391392 PMCID: PMC5427161 DOI: 10.1007/s00421-017-3595-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/23/2017] [Indexed: 12/01/2022]
Abstract
Purpose The reliability of surface electromyography (sEMG) is typically modest even with rigorous methods, and therefore further improvements in sEMG reliability are desirable. This study compared the between-session reliability (both within participant absolute reliability and between-participant relative reliability) of sEMG amplitude from single vs. average of two distinct recording sites, for individual muscle (IM) and whole quadriceps (WQ) measures during voluntary and evoked contractions. Methods Healthy males (n = 20) performed unilateral isometric knee extension contractions: voluntary maximum and submaximum (60%), as well as evoked twitch contractions on two separate days. sEMG was recorded from two distinct sites on each superficial quadriceps muscle. Results Averaging two recording sites vs. using single site measures improved reliability for IM and WQ measurements during voluntary (16–26% reduction in within-participant coefficient of variation, CVW) and evoked contractions (40–56% reduction in CVW). Conclusions For sEMG measurements from large muscles, averaging the recording of two distinct sites is recommended as it improves within-participant reliability. This improved sensitivity has application to clinical and research measurement of sEMG amplitude.
Collapse
Affiliation(s)
- T G Balshaw
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK. .,Institute for Sports Research, Nanyang Technological University, Singapore, Singapore. .,Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Loughborough University, Leicestershire, UK.
| | - A Fry
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - T M Maden-Wilkinson
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.,Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield, UK
| | - P W Kong
- Institute for Sports Research, Nanyang Technological University, Singapore, Singapore.,Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - J P Folland
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.,Institute for Sports Research, Nanyang Technological University, Singapore, Singapore.,Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Loughborough University, Leicestershire, UK
| |
Collapse
|
20
|
Trulsson A, Miller M, Gummesson C, Garwicz M. Associations between altered movement patterns during single-leg squat and muscle activity at weight-transfer initiation in individuals with anterior cruciate ligament injury. BMJ Open Sport Exerc Med 2017; 2:e000131. [PMID: 28890799 PMCID: PMC5566258 DOI: 10.1136/bmjsem-2016-000131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about factors contributing to the altered movement patterns observed in many individuals with anterior cruciate ligament (ACL) injury. We addressed whether altered muscular activity is such a factor. Methods 16 participants with unilateral, non-reconstructed ACL rupture were scored for altered movement patterns according to Test for Substitution Patterns (TSP), which includes the single-leg squat (SLS). Surface electromyography (SEMG), was recorded in the lower extremities at initiation of weight-transfer from double-leg to single-leg stance (eyes closed), simulating the initiation of an SLS. Normalised SEMG amplitudes 200–300 ms after weight-transfer initiation were compared between injured and non-injured sides, and correlated to the TSP scores for the SLS. Peak absolute SEMG amplitudes during 5 TSP test movements were also compared between sides. Results At weight-transfer initiation, muscle activity was lower in the tibialis anterior, gastrocnemius and peroneus longus muscles on the injured side. Low muscle activity correlated moderately to worse TSP scores for the SLS for the gluteus medius (rs=−0.56, p=0.03), and gastrocnemius muscles (rs=−0.56, p=0.02). Median peak absolute amplitude during TSP movements was lower in the quadriceps, gastrocnemius and peroneus longus muscles on the injured side. Conclusions The altered patterns of muscle activity at weight-transfer initiation, correlations between lower activity at movement initiation and altered movement patterns during SLS and the altered peak amplitudes during TSP movements together indicate alterations in sensorimotor control that may contribute to the observed altered movement patterns. Future studies will determine if exercises targeting muscle activity initiation should complement customary ACL injury rehabilitation.
Collapse
Affiliation(s)
- Anna Trulsson
- Department of Health Sciences, Physiotherapy, Lund University, Lund, Sweden.,Department of Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
| | - Michael Miller
- Department of Health Sciences, Physiotherapy, Lund University, Lund, Sweden
| | - Christina Gummesson
- Faculty of Medicine, Center for Teaching and Learning, Lund University, Lund, Sweden
| | - Martin Garwicz
- Department of Experimental Medical Science, Neuronano Research Center, Lund University, Lund, Sweden
| |
Collapse
|
21
|
Dingenen B, Janssens L, Luyckx T, Claes S, Bellemans J, Staes FF. Lower extremity muscle activation onset times during the transition from double-leg stance to single-leg stance in anterior cruciate ligament injured subjects. Hum Mov Sci 2015; 44:234-45. [PMID: 26409102 DOI: 10.1016/j.humov.2015.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 09/16/2015] [Accepted: 09/17/2015] [Indexed: 12/15/2022]
Abstract
The goal of this study was to evaluate muscle activation onset times (MAOT) of both legs during a transition task from double-leg stance (DLS) to single-leg stance (SLS) in anterior cruciate ligament injured (ACLI) (n=15) and non-injured control subjects (n=15) with eyes open and eyes closed. Significantly delayed MAOT were found in the ACLI group compared to the control group for vastus lateralis, vastus medialis obliquus, hamstrings medial, hamstrings lateral, tibialis anterior, peroneus longus and gastrocnemius in both vision conditions, for gluteus maximus and gluteus medius with eyes open and for tensor fascia latae with eyes closed. Within the ACLI group, delayed MAOT of tibialis anterior with eyes open and gastrocnemius with eyes closed were found in the injured leg compared to the non-injured leg. All other muscles were not significantly different between legs. In conclusion, the ACLI group showed delayed MAOT not only around the knee, but also at the hip and ankle muscles compared to the non-injured control group. No differences between both legs of the ACLI group were found, except for tibialis anterior and gastrocnemius. These findings indirectly support including central nervous system re-education training to target the underlying mechanisms of these altered MAOT after ACL injury.
Collapse
Affiliation(s)
- Bart Dingenen
- KU Leuven Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Tervuursevest 101 b1501, 3001 Heverlee, Belgium.
| | - Luc Janssens
- KU Leuven Department of Electrical Engineering, Faculty of Engineering Technology Services, Andreas Vesaliusstraat 13, 3000 Leuven, Belgium; KU Leuven Cardiovascular and Respiratory Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Tervuursevest 101 b1501, 3001 Heverlee, Belgium.
| | - Thomas Luyckx
- Department of Orthopedics, University Hospitals Leuven, Campus Pellenberg, Leuven, Weligerveld 1, 3212 Pellenberg, Belgium.
| | - Steven Claes
- Department of Orthopedics, University Hospitals Leuven, Campus Pellenberg, Leuven, Weligerveld 1, 3212 Pellenberg, Belgium; Department of Orthopedic Surgery, AZ Herentals Hospital, Nederrij 133, 2200 Herentals, Belgium.
| | - Johan Bellemans
- Department of Orthopedics, University Hospitals Leuven, Campus Pellenberg, Leuven, Weligerveld 1, 3212 Pellenberg, Belgium.
| | - Filip F Staes
- KU Leuven Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Tervuursevest 101 b1501, 3001 Heverlee, Belgium.
| |
Collapse
|