Background:Changes in lower limb joint coordination have been shown to increase localized stress on knee joint soft tissue—a known precursor of osteoarthritis.While 50%of individuals who undergo anterior cruciate lig...Background:Changes in lower limb joint coordination have been shown to increase localized stress on knee joint soft tissue—a known precursor of osteoarthritis.While 50%of individuals who undergo anterior cruciate ligament reconstruction(ACLR)develop radiographic osteoarthritis,it is unclear how underlying joint coordination during gait changes post-ACLR.The purpose of this study was twofold:to determine differences in lower limb coordination patterns during gait in ACLR individuals 2,4,and 6 months post-ACLR and to compare the coordination profiles of the ACLR participants at each timepoint post-ACLR to uninjured matched controls.Methods:We conducted a longitudinal assessment to quantify lower limb coordination at 3 timepoints post-ACLR and compared the ACLR coordination profiles to uninjured controls.Thirty-four ACLR(age=21.43±4.24 years,mean±SD;70.59%female)and 34 controls(age=21.42±3.43 years;70.59%female)participated.The ACLR group completed 3 overground gait assessments(2,4,and 6 months post-ACLR),and the controls completed one assessment,at which lower limb kinematics were collected.Cross-recurrence quantification analysis was used to characterize sagittal and frontal plane ankle-knee,ankle-hip,and knee-hip coordination dynamics.Comprehensive general linear mixed models were constructed to compare between-limb and within-limb coordination outcomes over time post-ACLR and a between-group comparison across timepoints.Results:The ACLR limb demonstrated a more"stuck"sagittal plane knee-hip coordination profile(greater trapping time(TT);p=0.004)compared bilaterally.Between groups,the ACLR participants exhibited a more predictable ankle-knee coordination pattern(percent determinism(%DET);p<0.05),stronger coupling between joints(meanline(MNLine))across all segments(p<0.05),and greater knee-hip TT(more"stuck";p<0.05)compared to the controls at each timepoint in the sagittal plane.Stronger frontal plane knee-hip joint coupling(MNLine)persisted across timepoints within the ACLR group compared to the controls(p<0.05).Conclusion:The results indicate ACLR individuals exhibit a distinct and rigid coordination pattern during gait compared to controls within6-month post-ACLR,which may have long-term implications for knee-joint health.展开更多
基金supported by the Arthritis Foundation(principal investigator:BP)the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health(P30-AR072580)。
文摘Background:Changes in lower limb joint coordination have been shown to increase localized stress on knee joint soft tissue—a known precursor of osteoarthritis.While 50%of individuals who undergo anterior cruciate ligament reconstruction(ACLR)develop radiographic osteoarthritis,it is unclear how underlying joint coordination during gait changes post-ACLR.The purpose of this study was twofold:to determine differences in lower limb coordination patterns during gait in ACLR individuals 2,4,and 6 months post-ACLR and to compare the coordination profiles of the ACLR participants at each timepoint post-ACLR to uninjured matched controls.Methods:We conducted a longitudinal assessment to quantify lower limb coordination at 3 timepoints post-ACLR and compared the ACLR coordination profiles to uninjured controls.Thirty-four ACLR(age=21.43±4.24 years,mean±SD;70.59%female)and 34 controls(age=21.42±3.43 years;70.59%female)participated.The ACLR group completed 3 overground gait assessments(2,4,and 6 months post-ACLR),and the controls completed one assessment,at which lower limb kinematics were collected.Cross-recurrence quantification analysis was used to characterize sagittal and frontal plane ankle-knee,ankle-hip,and knee-hip coordination dynamics.Comprehensive general linear mixed models were constructed to compare between-limb and within-limb coordination outcomes over time post-ACLR and a between-group comparison across timepoints.Results:The ACLR limb demonstrated a more"stuck"sagittal plane knee-hip coordination profile(greater trapping time(TT);p=0.004)compared bilaterally.Between groups,the ACLR participants exhibited a more predictable ankle-knee coordination pattern(percent determinism(%DET);p<0.05),stronger coupling between joints(meanline(MNLine))across all segments(p<0.05),and greater knee-hip TT(more"stuck";p<0.05)compared to the controls at each timepoint in the sagittal plane.Stronger frontal plane knee-hip joint coupling(MNLine)persisted across timepoints within the ACLR group compared to the controls(p<0.05).Conclusion:The results indicate ACLR individuals exhibit a distinct and rigid coordination pattern during gait compared to controls within6-month post-ACLR,which may have long-term implications for knee-joint health.
