Program in Human Movement Science, University of North Carolina at Chapel Hill, United States; MOTION Science Institute, University of North Carolina at Chapel Hill, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, United States.
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, United States.
J Biomech. 2022 Mar;134:110989. doi: 10.1016/j.jbiomech.2022.110989. Epub 2022 Feb 5.
Aberrant gait biomechanics following anterior cruciate ligament reconstruction (ACLR) likely contribute to post-traumatic osteoarthritis (PTOA) development. Gait biomechanics are typically assessed overground, but the use of instrumented/force-measuring treadmills is increasingly common. The purpose of this study was to compare gait biomechanics overground and on an instrumented treadmill in individuals with ACLR and healthy controls. Twenty-four individuals with ACLR and 24 healthy controls completed overground and gait biomechanics assessments. Biomechanical outcomes included peak vertical ground reaction force (vGRF), internal knee extension (KEM) and abduction (KAM) moments, and knee flexion (KFA) and adduction angles; KFA at heel strike; knee flexion displacement; and inter-limb symmetry for each outcome. Peak KEM (P < 0.001, 95%CI [-0.016, -0.007 xBWHt]) and vGRF (P < 0.001, 95%CI [-0.09. -0.03 xBW]) were significantly less symmetrical in the ACLR group compared to the control group on the treadmill but not overground. Additionally, peak KEM was smaller in the ACLR limb compared to the contralateral limb both overground (P = 0.005, 95%CI [-0.010, -0.001 xBWHt]) and on the treadmill (P < 0.001, 95%CI [-0.015, -0.007 xBW*Ht]), but this difference was 1.8x larger on the treadmill compared to overground. Peak KFA (P = 0.001, 95%CI [-4.2, -1.2°]) and vGRF (P < 0.001, 95%CI [-0.07, -0.03 xBW]) were smaller in the ACLR limb on the treadmill but not overground. These findings suggest aberrant gait biomechanics are exacerbated during treadmill walking post-ACLR and that evaluating kinematics and kinetics on instrumented treadmills may be valuable for assessing risk factors of PTOA development.
前交叉韧带重建（ACLR）后异常的步态生物力学可能导致创伤后骨关节炎（PTOA）的发展。步态生物力学通常在地面上进行评估，但使用仪器/测力跑步机的情况越来越普遍。本研究的目的是比较 ACLR 患者和健康对照组在地面和仪器跑步机上的步态生物力学。24 名 ACLR 患者和 24 名健康对照者完成了地面和步态生物力学评估。生物力学结果包括峰值垂直地面反作用力（vGRF）、膝关节内伸（KEM）和外展（KAM）力矩以及膝关节屈曲（KFA）和内收角度；跟骨触地时的 KFA；膝关节屈曲位移；以及每个结果的肢体对称性。与对照组相比，在跑步机上，ACL 组的 KEM 峰值（P<0.001，95%CI [-0.016，-0.007 xBWHt]）和 vGRF（P<0.001，95%CI [-0.09，-0.03 xBW]）明显不对称，但在地面上则不然。此外，在地面上（P=0.005，95%CI [-0.010，-0.001 xBWHt]）和跑步机上（P<0.001，95%CI [-0.015，-0.007 xBW*Ht]），ACL 肢体的 KEM 峰值明显小于对侧肢体，但在跑步机上的差异比地面上大 1.8 倍。在跑步机上（P=0.001，95%CI [-4.2，-1.2°]）和地面上（P<0.001，95%CI [-0.07，-0.03 xBW]），ACL 肢体的 KFA 峰值和 vGRF 均较小。这些发现表明，ACL 重建后，跑步机行走时的步态生物力学异常加剧，在仪器跑步机上评估运动学和动力学可能有助于评估 PTOA 发展的危险因素。
