Department of Exercise Science & Athletic Training, Adrian College, Adrian, MI.
Department of Kinesiology, and Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.
Med Sci Sports Exerc. 2018 Nov;50(11):2209-2216. doi: 10.1249/MSS.0000000000001693.
To examine knee and hip biomechanics during walking and jogging in groups of ACLR patients at early, mid, and late time frames postsurgery and healthy controls.
Participants included individuals with a history of primary, unilateral ACLR, stratified into early (1.4 ± 0.4 yr post, n = 18), mid (3.3 ± 0.6 yr post, n = 20), and late (8.5 ± 2.8 yr post, n = 20) ACLR groups based on time postsurgery, and a healthy control group (n = 20). Walking and jogging motion capture analysis of knee and hip kinetics and kinematics were measured in the sagittal and frontal planes. Interlimb (within groups) and between-group comparisons were performed for all gait variables. Statistical comparisons were made across the gait cycle by plotting graphs of means and 90% confidence intervals and identifying regions of the gait cycle in which the 90% confidence intervals did not overlap.
Early ACLR group demonstrated reduced knee flexion, knee extension, knee adduction, and hip adduction moments on the ACLR limb. Mid ACLR group demonstrated no gait differences between limbs or other groups. Late ACLR group demonstrated reduced knee flexion moments, and greater knee and hip adduction moments in their ACLR limb. Control group demonstrated no interlimb differences.
Walking and jogging gait biomechanics presented differently in patients at different stages in time after ACLR surgery. The early ACLR group demonstrated lower sagittal and frontal plane joint loading on the ACLR limb compared with contralateral and control limbs. The mid ACLR group did not demonstrate any gait differences compared with the contralateral or control limb. The late ACLR group demonstrated lower sagittal plane joint loading compared with control limbs and greater frontal plane joint loading compared to contralateral and control limbs.
研究 ACLR 术后早期、中期和晚期患者组及健康对照组在行走和慢跑时膝关节和髋关节的生物力学。
参与者包括有单侧 ACLR 病史的个体，根据术后时间分为 ACLR 术后早期（1.4 ± 0.4 年，n = 18）、中期（3.3 ± 0.6 年，n = 20）和晚期（8.5 ± 2.8 年，n = 20）组，以及健康对照组（n = 20）。在矢状面和额状面测量膝关节和髋关节动力学和运动学的行走和慢跑运动捕捉分析。对所有步态变量进行组内和组间比较。通过绘制平均值和 90%置信区间的图形并确定步态周期中 90%置信区间不重叠的区域，对整个步态周期进行统计比较。
早期 ACLR 组 ACLR 侧膝关节屈曲、伸展、内收和内收力矩减小。中期 ACLR 组双侧肢体或其他组之间无步态差异。晚期 ACLR 组 ACLR 侧膝关节屈曲力矩减小，膝关节和髋关节内收力矩增大。对照组双侧肢体无差异。
ACL 术后不同时间点的患者行走和慢跑步态生物力学表现不同。早期 ACLR 组 ACLR 侧矢状面和额状面关节受力低于对侧和对照组。中期 ACLR 组与对侧或对照组相比，无任何步态差异。晚期 ACLR 组与对照组相比，矢状面关节受力降低，额状面关节受力增加。
