1
|
Escamilla RF. My Top Five Concepts for Selecting Lower Extremity Exercises For Cruciate Ligament and Patellofemoral Rehabilitation. Int J Sports Phys Ther 2023; 18:14-25. [PMID: 36793575 PMCID: PMC9897005 DOI: 10.26603/001c.65896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/02/2022] [Indexed: 02/04/2023] Open
Abstract
This clinical commentary will address five key concepts that can be used by clinicians as criteria for selecting lower extremity weight bearing exercises (WBE) and non-weight bearing exercises (NWBE) employed for cruciate ligament and patellofemoral rehabilitation. The following will be discussed for both cruciate ligament and patellofemoral rehabilitation: 1) Knee loading varies between WBE and NWBE; 2) Knee loading varies with technique variations within WBE and NWBE; 3) Knee loading varies between different WBE; 4) Knee loading varies as a function of knee angle; and 5) Knee loading increases with increased knee anterior translation beyond toes.
Collapse
Affiliation(s)
- Rafael F Escamilla
- Department of Physical Therapy California State University
- Results Physical Therapy and Training Center
| |
Collapse
|
2
|
Effect of Forefoot–Rearfoot and Pelvic–Scapular Weight Shifts on Lower-Limb and Lumbar Muscle Activity during Static Wall-Squat Exercises. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12084037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
(1) Background: The static body-weight wall-squat (SBWS) exercise is often included in the early rehabilitation stages of the lower limb. To establish its effectiveness and optimise its application, it is important to precisely quantify the muscle contribution to different versions of this exercise. (2) Methods: We analysed the electromyographic activity of lower limb and lumbar muscles during the SBWS with knees flexed at 45° by manipulating three different variables: horizontal distance of the ankles from the wall; scapular or pelvic location of the centre of pressure Cwall of the force exerted by the wall on the back; rearfoot or forefoot location of the centre of pressure CGR of the ground reaction force. (3) Results: The forefoot-to-rearfoot CGR shift significantly increased the vastus medialis, vastus lateralis, and tibialis anterior activity up to 23%, 26%, and 44% of the maximum voluntary isometric contraction (MVIC). The lumbar muscle activity was maximised (23% MVIC) shifting CGR at the forefoot, Cwall at the scapular zone, and placing the feet far from the wall. (4) Conclusions: These SBWS methods might be effective for quadriceps, tibialis anterior, and lumbar muscles strengthening in the early phase of rehabilitation intervention as soon as the patient can tolerate partial weight-bearing. The exercise appears suitable for patients with low back pain and limited lumbar muscle endurance, or quadriceps weakness and inhibition secondary to a knee injury.
Collapse
|
3
|
Logerstedt DS, Ebert JR, MacLeod TD, Heiderscheit BC, Gabbett TJ, Eckenrode BJ. Effects of and Response to Mechanical Loading on the Knee. Sports Med 2021; 52:201-235. [PMID: 34669175 DOI: 10.1007/s40279-021-01579-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 11/30/2022]
Abstract
Mechanical loading to the knee joint results in a differential response based on the local capacity of the tissues (ligament, tendon, meniscus, cartilage, and bone) and how those tissues subsequently adapt to that load at the molecular and cellular level. Participation in cutting, pivoting, and jumping sports predisposes the knee to the risk of injury. In this narrative review, we describe different mechanisms of loading that can result in excessive loads to the knee, leading to ligamentous, musculotendinous, meniscal, and chondral injuries or maladaptations. Following injury (or surgery) to structures around the knee, the primary goal of rehabilitation is to maximize the patient's response to exercise at the current level of function, while minimizing the risk of re-injury to the healing tissue. Clinicians should have a clear understanding of the specific injured tissue(s), and rehabilitation should be driven by knowledge of tissue-healing constraints, knee complex and lower extremity biomechanics, neuromuscular physiology, task-specific activities involving weight-bearing and non-weight-bearing conditions, and training principles. We provide a practical application for prescribing loading progressions of exercises, functional activities, and mobility tasks based on their mechanical load profile to knee-specific structures during the rehabilitation process. Various loading interventions can be used by clinicians to produce physical stress to address body function, physical impairments, activity limitations, and participation restrictions. By modifying the mechanical load elements, clinicians can alter the tissue adaptations, facilitate motor learning, and resolve corresponding physical impairments. Providing different loads that create variable tensile, compressive, and shear deformation on the tissue through mechanotransduction and specificity can promote the appropriate stress adaptations to increase tissue capacity and injury tolerance. Tools for monitoring rehabilitation training loads to the knee are proposed to assess the reactivity of the knee joint to mechanical loading to monitor excessive mechanical loads and facilitate optimal rehabilitation.
Collapse
Affiliation(s)
- David S Logerstedt
- Department of Physical Therapy, University of the Sciences in Philadelphia, Philadelphia, PA, USA.
| | - Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia.,Orthopaedic Research Foundation of Western Australia, Perth, WA, Australia.,Perth Orthopaedic and Sports Medicine Research Institute, Perth, WA, Australia
| | - Toran D MacLeod
- Department of Physical Therapy, Sacramento State University, Sacramento, CA, USA
| | - Bryan C Heiderscheit
- Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Tim J Gabbett
- Gabbett Performance Solutions, Brisbane, QLD, Australia.,Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia
| | - Brian J Eckenrode
- Department of Physical Therapy, Arcadia University, Glenside, PA, USA
| |
Collapse
|
4
|
Bartolin PB, Boixadera R, Hudetz D. Experimental testing and finite element method analysis of the anterior cruciate ligament primary repair with internal brace augmentation. Med Eng Phys 2021; 95:76-83. [PMID: 34479695 DOI: 10.1016/j.medengphy.2021.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 11/25/2022]
Abstract
The internal brace (IB) technique is a promising treatment option for repairing the proximal rupture of the anterior cruciate ligament (ACL). This paper presents a biomechanical evaluation of the IB technique. Sixteen cadaveric sheep knees underwent monotonic tensile tests, cyclic loading, and passive flexion-extension testing. Data were compared in a series of eight control specimens with an intact ACL and eight repaired specimens where the ACL was cut and repaired using the IB. In parallel with the mechanical testing, finite element analysis (FEA) was performed to investigate the influence of IB loading on the femur-ACL-tibia complex (FATC). The 3D geometry of the FATC was reconstructed from CT scans of the sheep. The IB 3D model was integrated with the 3D FATC for FEA to obtain the femur-repaired ACL with IB - tibia complex (FRA-IB-TC) group. For the intact specimens, the mean (±SD) failure load in the tensile testing was 937 N (±192 N), while for the FRA-IB-TC specimens, it was 519 N (±52 N). The FRA-IB-TC remained biomechanically stable during the cyclic loading testing. The FEA demonstrated an increase in ACL stress to 24.59 MPa and displacement values of 0.391 mm. The IB construct exhibited shear and notch effects at the button-suture-bone fixation site. Testing on this sheep model allowed us a parametric analysis of the impact of the IB repair technique. However, the results will need to be confirmed in a human model. In conclusion, although the IB technique has biomechanical drawbacks, the mechanical properties of the technique are satisfactory.
Collapse
Affiliation(s)
- Petra Bonačić Bartolin
- PhD Student/Teaching Assistant at the Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia.
| | - Rachel Boixadera
- Medical Student at University of Cambridge, Cambridge, United Kingdom
| | - Damir Hudetz
- Faculty of Medicine, Assistant Professor at the University of Osijek, Osijek, Croatia
| |
Collapse
|
5
|
Floyd ER, Carlson GB, Monson J, LaPrade RF. Multiple Ligament Reconstructions of the Knee and Posterolateral Corner. Arthrosc Tech 2021; 10:e1269-e1280. [PMID: 34141542 PMCID: PMC8185621 DOI: 10.1016/j.eats.2021.01.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/29/2021] [Indexed: 02/03/2023] Open
Abstract
Injuries to the knee involving multiple ligaments occur in a variety of circumstances and require careful assessment and planning. A wide constellation of injuries can occur with causes sufficiently traumatic to produce bicruciate ligament deficiency, and this technical report will describe diagnosis, treatment and rehabilitation for a knee dislocation with lateral injury (KD-III-L on the Schenk classification). Reconstruction in the acute setting is preferred, with anatomic-based, single-bundle anterior cruciate ligament reconstruction, double-bundle posterior cruciate ligament reconstruction, and anatomic reconstruction of the posterolateral corner using two grafts for the 3 primary posterolateral corner stabilizers. Tunnel orientation to prevent convergence and sequence of graft tensioning and fixation are discussed as well. Successful outcomes have been achieved using these anatomic-based reconstruction techniques along with appropriate rehabilitation and bracing.
Collapse
Affiliation(s)
- Edward R. Floyd
- Twin Cities Orthopedics, Edina-Crosstown, Edina, Minnesota,Georgetown University School of Medicine, Washington, District of Columbia
| | | | - Jill Monson
- Training Haus, Twin Cities Orthopedics, Eagan–Viking Lakes, Minnesota
| | - Robert F. LaPrade
- Twin Cities Orthopedics, Edina-Crosstown, Edina, Minnesota,Address correspondence to Robert F. LaPrade, M.D., Ph.D., Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St., Edina, MN 55435-1706, U.S.A.
| |
Collapse
|
6
|
Englander ZA, Lau BC, Wittstein JR, Goode AP, DeFrate LE. Patellar Tendon Orientation and Strain Are Predictors of ACL Strain In Vivo During a Single-Leg Jump. Orthop J Sports Med 2021; 9:2325967121991054. [PMID: 33796591 PMCID: PMC7983247 DOI: 10.1177/2325967121991054] [Citation(s) in RCA: 3] [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: 09/22/2020] [Accepted: 10/23/2020] [Indexed: 11/25/2022] Open
Abstract
Background: There is little in vivo data that describe the relationships between patellar
tendon orientation, patellar tendon strain, and anterior cruciate ligament
(ACL) strain during dynamic activities. Quantifying how the quadriceps load
the ACL via the patellar tendon is important for understanding ACL injury
mechanisms. Hypothesis: We hypothesized that flexion angle, patellar tendon orientation, and patellar
tendon strain influence ACL strain during a single-leg jump. Specifically,
we hypothesized that patellar tendon and ACL strains would increase
concurrently when the knee is positioned near extension during the jump. Study Design: Descriptive laboratory study. Methods: Models of the femur, tibia, ACL, patellar tendon, and quadriceps tendon
attachment sites of 8 male participants were generated from magnetic
resonance imaging (MRI). High-speed biplanar radiographs during a single-leg
jump were obtained. The bone models were registered to the radiographs,
thereby reproducing the in vivo positions of the bones, ligament, and tendon
attachment sites. Flexion angle, patellar tendon orientation, patellar
tendon strain, and ACL strain were measured from the registered models. ACL
and patellar tendon strains were approximated by normalizing their length at
each knee position to their length at the time of MRI. Two separate
bivariate linear regression models were used to assess relationships between
flexion angle and patellar tendon orientation and between ACL strain and
patellar tendon strain. A multivariate linear regression model was used to
assess whether flexion angle and patellar tendon strain were significant
predictors of ACL strain during the inflight and landing portions of the
jump. Results: Both flexion angle and patellar tendon strain were significant predictors
(P < .05) of ACL strain. These results indicate that
elevated ACL and patellar tendon strains were observed concurrently when the
knee was positioned near extension. Conclusion: Concurrent increases in patellar tendon and ACL strains indicate that the
quadriceps load the ACL via the patellar tendon when the knee is positioned
near extension. Clinical Relevance: Increased ACL strain when the knee is positioned near extension before
landing may be due to quadriceps contraction. Thus, landing with
unanticipated timing on an extended knee may increase vulnerability to ACL
injury as a taut ligament is more likely to fail.
Collapse
Affiliation(s)
- Zoë A Englander
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.,Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA.,Duke Sport Science Institute, Department of Orthopaedics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brian C Lau
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.,Duke Sport Science Institute, Department of Orthopaedics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jocelyn R Wittstein
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.,Duke Sport Science Institute, Department of Orthopaedics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Adam P Goode
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.,Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.,Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA.,Duke Sport Science Institute, Department of Orthopaedics, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA
| |
Collapse
|
7
|
Yang H, Bayoglu R, Clary CW, Rullkoetter PJ. Impact of surgical alignment, tray material, PCL condition, and patient anatomy on tibial strains after TKA. Med Eng Phys 2021; 88:69-77. [PMID: 33485516 DOI: 10.1016/j.medengphy.2021.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/04/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
Bone remodeling after total knee arthroplasty is regulated by the changes in strain energy density (SED), however, the critical parameters influencing post-operative SED distributions are not fully understood. This study aimed to investigate the impact of surgical alignment, tray material properties, posterior cruciate ligament (PCL) balance, tray posterior slope, and patient anatomy on SED distributions in the proximal tibia. Finite element models of two tibiae (different anatomy) with configurations of two implant materials, two surgical alignments, two posterior slopes, and two PCL conditions were developed. The models were tested under the peak loading conditions during gait, deep knee bending, and stair descent. For each configuration, the contact forces and locations and soft-tissue loads of interest were taken into consideration. SED in the proximal tibia was predicted and the changes in strain distributions were compared for each of the factors studied. Tibial anatomy had the most impact on the proximal bone SED distributions, followed by PCL balancing, surgical alignment, and posterior slope. In addition, the thickness of the remaining cortical wall after implantation was also a significant consideration when evaluating tibial anatomy. The resulting SED changes for alignment, posterior slope, and PCL factors were mainly due to the differences in joint and soft-tissue loading conditions. A lower modulus tray material did result in changes in the post-operative strain state, however, these were almost negligible compared to that seen for the other factors.
Collapse
Affiliation(s)
- Huizhou Yang
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO 80208, USA
| | - Riza Bayoglu
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO 80208, USA
| | - Chadd W Clary
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO 80208, USA
| | - Paul J Rullkoetter
- Center for Orthopaedic Biomechanics, University of Denver, 2155 E. Wesley Ave., Denver, CO 80208, USA.
| |
Collapse
|
8
|
Keizer MNJ, Hijmans JM, Gokeler A, Benjaminse A, Otten E. Healthy subjects with lax knees use less knee flexion rather than muscle control to limit anterior tibia translation during landing. J Exp Orthop 2020; 7:32. [PMID: 32415565 PMCID: PMC7229106 DOI: 10.1186/s40634-020-00246-6] [Citation(s) in RCA: 4] [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: 03/26/2020] [Accepted: 04/28/2020] [Indexed: 02/01/2023] Open
Abstract
Purpose It has been reported that there is no correlation between anterior tibia translation (ATT) in passive and dynamic situations. Passive ATT (ATTp) may be different to dynamic ATT (ATTd) due to muscle activation patterns. This study aimed to investigate whether muscle activation during jumping can control ATT in healthy participants. Methods ATTp of twenty-one healthy participants was measured using a KT-1000 arthrometer. All participants performed single leg hops for distance during which ATTd, knee flexion angles and knee flexion moments were measured using a 3D motion capture system. During both tests, sEMG signals were recorded. Results A negative correlation was found between ATTp and the maximal ATTd (r = − 0.47, p = 0.028). An N-Way ANOVA showed that larger semitendinosus activity was seen when ATTd was larger, while less biceps femoris activity and rectus femoris activity were seen. Moreover, larger knee extension moment, knee flexion angle and ground reaction force in the anterior-posterior direction were seen when ATTd was larger. Conclusion Participants with more ATTp showed smaller ATTd during jump landing. Muscle activation did not contribute to reduce ATTd during impact of a jump-landing at the observed knee angles. However, subjects with large ATTp landed with less knee flexion and consequently showed less ATTd. The results of this study give information on how healthy people control knee laxity during jump-landing. Level of evidence III
Collapse
Affiliation(s)
- Michèle N J Keizer
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, UMCG sector F, FA 23, PO Box 219, Groningen, 9713AV, The Netherlands.
| | - Juha M Hijmans
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alli Gokeler
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, UMCG sector F, FA 23, PO Box 219, Groningen, 9713AV, The Netherlands.,Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg.,Department Exercise & Health, Exercise Science and Neuroscience, University of Paderborn, Paderborn, Germany
| | - Anne Benjaminse
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, UMCG sector F, FA 23, PO Box 219, Groningen, 9713AV, The Netherlands.,School of Sport Studies, Hanze University Groningen, Groningen, The Netherlands
| | - Egbert Otten
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, UMCG sector F, FA 23, PO Box 219, Groningen, 9713AV, The Netherlands
| |
Collapse
|
9
|
Joint Torques and Tibiofemoral Joint Reaction Force in the Bodyweight “Wall Squat” Therapeutic Exercise. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10093019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study provides a biomechanical analysis of the bodyweight wall-squat exercise considering four exercise variants: knee angle; horizontal hip-ankle distance (d); shift between the rearfoot and forefoot of the centre of pressure (xGR) of the ground reaction force; back supported via the scapular or pelvic zone. The ankle and hip angles corresponding to a given knee angle can be modulated, changing the distance d, to manage limitation in lumbopelvic and ankle mobility. The knee-extensor muscles can be overloaded (250 Nm muscle torque) with knees flexed at 90°, back supported through the pelvic zone, and feet away from the wall (d = 50 cm). Scapular support, xGR at forefoot, and d = 50 cm, yield a higher level of muscle-torque for hip-extension (130 Nm) and knee-flexion (65 Nm), with knees at 90° of flexion or near full extension, respectively. Ankle-dorsiflexion (plantarflexion) muscle torque up to 40 Nm is reached with xGR at the forefoot (rearfoot). This study may aid trainers and therapists to finely modulate the muscle torques (up to the above-mentioned levels) by an appropriate selection of exercise variants for training or rehabilitation purposes. Low levels (60 N) of anterior tibial pull may occur near 25° of knee flexion with x GR at the rearfoot.
Collapse
|
10
|
Trulsson A, Miller M, Hansson GÅ, Gummesson C, Garwicz M. Altered movement patterns and muscular activity during single and double leg squats in individuals with anterior cruciate ligament injury. BMC Musculoskelet Disord 2015; 16:28. [PMID: 25887306 PMCID: PMC4333170 DOI: 10.1186/s12891-015-0472-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 01/16/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Individuals with Anterior Cruciate Ligament (ACL) injury often show altered movement patterns, suggested to be partly due to impaired sensorimotor control. Here, we therefore aimed to assess muscular activity during movements often used in ACL-rehabilitation and to characterize associations between deviations in muscular activity and specific altered movement patterns, using and further exploring the previously developed Test for substitution Patterns (TSP). METHODS Sixteen participants (10 women) with unilateral ACL rupture performed Single and Double Leg Squats (SLS; DLS). Altered movement patterns were scored according to TSP, and Surface Electromyography (SEMG) was recorded bilaterally in six hip, thigh and shank muscles. To quantify deviations in muscular activity, SEMG ratios were calculated between homonymous muscles on injured and non-injured sides, and between antagonistic muscles on the same side. Correlations between deviations of injured/non-injured side SEMG ratios and specific altered movement patterns were calculated. RESULTS Injured/non-injured ratios were low at transition from knee flexion to extension in quadriceps in SLS, and in quadriceps and hamstrings in DLS. On injured side, the quadriceps/hamstrings ratio prior to the beginning of DLS and end of DLS and SLS, and tibialis/gastrocnemius ratio at end of DLS were lower than on non-injured side. Correlations were found between specific altered movement patterns and deviating muscular activity at transition from knee flexion to extension in SLS, indicating that the more deviating the muscular activity on injured side, the more pronounced the altered movement pattern. "Knee medial to supporting foot" correlated to lower injured/non-injured ratios in gluteus medius (rs = -0.73, p = 0.001), "lateral displacement of hip-pelvis-region" to lower injured/non-injured ratios in quadriceps (rs = -0.54, p = 0.03) and "displacement of trunk" to higher injured/non-injured ratios in gluteus medius (rs = 0.62, p = 0.01). CONCLUSIONS Deviations in muscular activity between injured and non-injured sides and between antagonistic muscular activity within injured as compared to non-injured sides indicated specific alterations in sensorimotor control of the lower limb in individuals with ACL rupture. Also, correlations between deviating muscular activity and specific altered movement patterns were suggested as indications of altered sensorimotor control. We therefore advocate that quantitative assessments of altered movement patterns should be considered in ACL-rehabilitation.
Collapse
Affiliation(s)
- Anna Trulsson
- Department of Health Sciences, Physiotherapy, Lund University, Lund, Sweden. .,Department of Rehabilitation Medicine, Skane University Hospital, Lund, Sweden.
| | - Michael Miller
- Department of Health Sciences, Physiotherapy, Lund University, Lund, Sweden.
| | - Gert-Åke Hansson
- Occupational and Environmental Medicine, Lund University, and University and Regional Laboratories Region Scania, Lund, Sweden.
| | | | - Martin Garwicz
- Department of Experimental Medical Science, Neuronano Research Center, Lund University, Lund, Sweden.
| |
Collapse
|