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Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry.

作者信息

Knobel Rachel J, Ito Naoaki, Arhos Elanna K, Capin Jacob J, Buchanan Thomas S, Snyder-Mackler Lynn

机构信息

University of Delaware.

Department of Physical Medicine and Rehabilitation, University of Colorado; Eastern Colorado VA Geriatric Research Education and Clinical Center.

出版信息

Int J Sports Phys Ther. 2021 Feb 1;16(1):169-176. doi: 10.26603/001c.18710.


DOI:10.26603/001c.18710
PMID:33604147
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7872452/
Abstract

BACKGROUND: Gait asymmetries after anterior cruciate ligament reconstruction (ACLR) may lead to radiographic knee osteoarthritis. Slower walking speeds have been associated with biomarkers suggesting cartilage breakdown. The relationship between walking speed and gait symmetry after ACLR is unknown. HYPOTHESIS/PURPOSE: To determine the relationship between self-selected walking speeds and gait symmetry in athletes after primary, unilateral ACLR. STUDY DESIGN: Secondary analysis of a clinical trial. METHODS: Athletes 24±8 weeks after primary ACLR walked at self-selected speeds as kinematics, kinetics, and electromyography data were collected. An EMG-driven musculoskeletal model was used to calculate peak medial compartment contact force (pMCCF). Variables of interest were peak knee flexion moment (pKFM) and angle (pKFA), knee flexion and extension (KEE) excursions, peak knee adduction moment (pKAM), and pMCCF. Univariate correlations were run for walking speed and each variable in the ACLR knee, contralateral knee, and interlimb difference (ILD). RESULTS: Weak to moderate positive correlations were observed for walking speed and all variables of interest in the contralateral knee (Pearson's r=.301-.505, p≤0.01). In the ACLR knee, weak positive correlations were observed for only pKFM (r=.280, p=0.02) and pKFA (r=.263, p=0.03). Weak negative correlations were found for ILDs in pKFM (r=-0.248, p=0.04), KEE (r=-.260, p=0.03), pKAM (r=-.323, p<0.01), and pMCCF (r=-.286, p=0.02). CONCLUSION: Those who walk faster after ACLR have more asymmetries, which are associated with the development of early OA. This data suggests that interventions that solely increase walking speed may accentuate gait symmetry in athletes early after ACLR. Gait-specific, unilateral, neuromuscular interventions for the ACLR knee may be needed to target gait asymmetries after ACLR. LEVEL OF EVIDENCE: III.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/d98617495f9a/ijspt_2021_16_1_18710_50162.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/78a476fc6956/ijspt_2021_16_1_18710_49329.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/a863ebd7b363/ijspt_2021_16_1_18710_49328.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/d9c55b0e41f4/ijspt_2021_16_1_18710_50161.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/d98617495f9a/ijspt_2021_16_1_18710_50162.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/78a476fc6956/ijspt_2021_16_1_18710_49329.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/a863ebd7b363/ijspt_2021_16_1_18710_49328.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/d9c55b0e41f4/ijspt_2021_16_1_18710_50161.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca6/7872452/d98617495f9a/ijspt_2021_16_1_18710_50162.jpg

相似文献

[1]
Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry.

Int J Sports Phys Ther. 2021-2-1

[2]
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Am J Sports Med. 2021-2

[3]
Report of the Primary Outcomes for Gait Mechanics in Men of the ACL-SPORTS Trial: Secondary Prevention With and Without Perturbation Training Does Not Restore Gait Symmetry in Men 1 or 2 Years After ACL Reconstruction.

Clin Orthop Relat Res. 2017-10

[4]
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[5]
Progressive Changes in Walking Kinematics and Kinetics After Anterior Cruciate Ligament Injury and Reconstruction: A Review and Meta-Analysis.

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[6]
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[7]
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Am J Sports Med. 2016-1

[8]
Inertial sensors identified asymmetries in shank angular velocity at different gait speeds in individuals with anterior cruciate ligament reconstruction.

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[9]
Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction.

J Orthop Res. 2019-11-18

[10]
Psychological Readiness to Return to Sport Is Associated With Knee Kinematic Asymmetry During Gait Following Anterior Cruciate Ligament Reconstruction.

J Orthop Sports Phys Ther. 2018-7-27

引用本文的文献

[1]
Tears, Tendons, and Trends: A Bibliometric Analysis on Anterior Cruciate Ligament Research.

Orthop Rev (Pavia). 2025-7-26

[2]
Motor Learning of Knee Joint Kinematics in Patients Within the First Year After ACL Reconstruction.

Sports Health. 2025-5-30

[3]
Beyond the surface: anterior cruciate ligament assessment in knee osteoarthritis.

Bone Joint Res. 2025-2-6

[4]
Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries?

Orthop Surg. 2024-4

[5]
Joint and Limb Loading during Gait in Adults with ACL Reconstruction: Comparison between Single-Step and Cumulative Load Metrics.

Med Sci Sports Exerc. 2023-9-1

[6]
Patellofemoral contact forces and knee gait mechanics 3 months after ACL reconstruction are associated with cartilage degradation 24 months after surgery.

Osteoarthritis Cartilage. 2023-1

[7]
Identifying Gait Pathology after ACL Reconstruction Using Temporal Characteristics of Kinetics and Electromyography.

Med Sci Sports Exerc. 2022-6-1

本文引用的文献

[1]
Bilateral Gait 6 and 12 Months Post-Anterior Cruciate Ligament Reconstruction Compared with Controls.

Med Sci Sports Exerc. 2020-4

[2]
Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction.

J Orthop Res. 2019-11-18

[3]
Marked increase in the incidence of anterior cruciate ligament reconstructions in young females in New Zealand.

ANZ J Surg. 2019-9

[4]
Gait Mechanics in Women of the ACL-SPORTS Randomized Control Trial: Interlimb Symmetry Improves Over Time Regardless of Treatment Group.

J Orthop Res. 2019-5-20

[5]
Loading Behaviors Do Not Match Loading Abilities Postanterior Cruciate Ligament Reconstruction.

Med Sci Sports Exerc. 2019-8

[6]
Gait Mechanics and T1ρ MRI of Tibiofemoral Cartilage 6 Months after ACL Reconstruction.

Med Sci Sports Exerc. 2019-4

[7]
Trends in Incidence of ACL Reconstruction and Concomitant Procedures Among Commercially Insured Individuals in the United States, 2002-2014.

Sports Health. 2018

[8]
Functional and Patient-Reported Outcomes Improve Over the Course of Rehabilitation: A Secondary Analysis of the ACL-SPORTS Trial.

Sports Health. 2018-6-20

[9]
Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2-3 years following anterior cruciate ligament reconstruction.

Knee Surg Sports Traumatol Arthrosc. 2018-6-7

[10]
Walking gait asymmetries 6 months following anterior cruciate ligament reconstruction predict 12-month patient-reported outcomes.

J Orthop Res. 2018-11

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