Postural stability and regulation before and after anterior cruciate ligament reconstruction - A two years longitudinal study.

OBJECTIVES

To evaluate postural regulation and stability among patients who underwent anterior cruciate ligament reconstruction (ACLR) and rehabilitation over a two-year follow-up period.

DESIGN

Longitudinal; SETTING: Biomechanics laboratory; PARTICIPANTS: 30 ACLR patients (32.0 ± 12.2 years, 14 males) with isolated ACL rupture.

MAIN OUTCOME MEASURES

Postural regulation was tested before ACLR, as well as at six-weeks, twelve-weeks, six-months, one-year and two-years post-ACLR and standardized rehabilitation. Postural regulation was measured for stability indicator (ST), weight distribution index (WDI), synchronization (foot coordination) and sway intensities (postural subsystems).

RESULTS

Significant time effects (pre-vs. two-years postoperative) were found for WDI (η = 0.466), synchronization (η = 0.368), mediolateral weight distribution (η = 0.349), ST (η = 0.205), visual/nigrostriatal systems (η = 0.179) and peripheral-vestibular system (η = 0.102). The largest difference (preoperative: η = 0.180) to the matched sample was calculated for WDI. The most significant differences to the matched sample were observed for ST (preoperative: η = 0.126; six-weeks postoperative: η = 0.103) and WDI (preoperative: η = 0.180; six-weeks postoperative: η = 0.174).

CONCLUSION

ACLR and rehabilitation influence postural subsystems, postural stability, weight distribution and foot synchronization. Normalization of mediolateral weight distribution requires one year following ACLR. The ACLR leads to a suppression of the somatosensory and cerebellar system which was compensated by a higher activity of the visual and nigrostriatal systems.