4.5 Article

Individuals following anterior cruciate ligament reconstruction practice underloading strategies during daily activity

期刊

JOURNAL OF ORTHOPAEDIC RESEARCH
卷 40, 期 3, 页码 565-572

出版社

WILEY
DOI: 10.1002/jor.25070

关键词

ACL; biomechanics; daily activities; learned nonuse; wearable sensors

资金

  1. National Center Medical Rehabilitation Research [K12 HD0055929]
  2. International Society of Biomechanics
  3. North American Society for the Psychology of Sport and Physical Activity

向作者/读者索取更多资源

Study found that individuals post-ACLr exhibit underloading behaviors in daily activities, consistent with previous biomechanical studies. This underloading is related to knee extensor weakness.
Underloading the surgical limb has been described in biomechanical studies across recovery time points following anterior cruciate ligament reconstruction (ACLr). This study aimed to examine the extent to which laboratory findings translate to daily activities. Limb loading was quantified during a sit-to-stand task in laboratory testing and throughout 2 days of daily activity in 15 individuals 114.8 (17.2) days post-ACLr and 15 controls. Vertical force impulse calculated from force platform (laboratory) and pressure insoles (daily) was used to quantify limb loading. Between-limb symmetry was calculated for limb loading and knee strength measures, 2 x 2 GLM repeated measures determined a significant group-by-limb interaction on daily limb loading. Surgical limb daily loading was lower compared to nonsurgical (p < .001; effect sizes [ES] = 0.63), and control matched limbs (surgical: p = .037, ES = 0.80 and nonsurgical: p = .02, ES = 0.89). No group differences were found in total daily loading (summed loading between limbs; p = .18; ES = 0.50) and time performing weight-bearing activities (p = .32; ES = 0.36). Pearson's correlation determined that between-limb symmetry in daily loading was related to sit-to-stand loading (r = .62; p = .01) and knee extensor strength symmetry (r = .6; p = .02) in the ACLr group. These data support the presence of underloading behaviors in individuals 10-14 weeks following ACLr that are consistent with previous biomechanical studies and current biomechanical data. Knee extensor weakness was related to greater underloading. Asymmetrical loading quantified in the laboratory is practiced throughout the day in individuals post-ACLr. Practice afforded by daily activities represents powerful contributors to learning of a pattern that contrasts the goal of rehabilitation exercises.

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