Increased movement variability in one-leg hops about 20 years after treatment of anterior cruciate ligament injury

Divya Srinivasan; Eva Tengman; Charlotte K Häger

doi:10.1016/j.clinbiomech.2018.02.003

Increased movement variability in one-leg hops about 20 years after treatment of anterior cruciate ligament injury

Clin Biomech (Bristol, Avon). 2018 Mar:53:37-45. doi: 10.1016/j.clinbiomech.2018.02.003. Epub 2018 Feb 6.

Authors

Divya Srinivasan¹, Eva Tengman², Charlotte K Häger²

Affiliations

¹ Dept. of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden; Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA. Electronic address: sdivya1@vt.edu.
² Dept. of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden.

PMID: 29433043
DOI: 10.1016/j.clinbiomech.2018.02.003

Abstract

Background: Recent studies highlight the need for understanding movement control of adjacent joints when evaluating knee function following anterior cruciate ligament (ACL) injury. However, while short-term adaptations to lower-extremity joint coupling have been studied, little is known about any potential long-term adaptations in neuromuscular control displayed by ACL-injured individuals. The aim of our study was to determine whether coordination variability of the hip-knee joint couplings during the one-leg hop is altered about 20 years after injury in two ACL-injured groups compared to healthy knee controls.

Methods: Seventy persons performed one leg hops ~23 years after ACL injury and following different treatments: 33 participants treated with physiotherapy in combination with ACL-reconstruction (ACL_R); 37 participants with physiotherapy alone (ACL_PT). They were compared to 33 matched controls. A vector coding procedure was used to create joint couplings for knee and hip angles on all the cardinal planes for the Take-off and Landing phases. The standard deviation of each coupling was computed as a measure of coordination variability.

Findings: Both the ACL groups differed significantly from controls on their injured side with ~50% higher knee abduction-adduction/hip internal-external rotation variability during the Take-off phase; ~33% higher knee abduction-adduction/knee flexion-extension variability and greater knee abduction-adduction/hip flexion-extension variability (ACL_R 50%; ACL_PT 80%) during the Landing phase. There were no major differences between injured and non-injured sides in any group.

Interpretation: Increased variability in lower-extremity joint couplings has emerged as a conspicuous feature of ACL injured persons in the very long term compared to non-injured controls, independent of treatment. Further research of the processes leading to alterations in movement variability using longitudinal studies would facilitate better understanding of the functional adaptations leading to knee dysfunction in the short- and long-term after ACL injury.

Keywords: ACL reconstruction; Kinematics; Movement variability; Physiotherapy; Vector coding.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anterior Cruciate Ligament Injuries / physiopathology*
Anterior Cruciate Ligament Injuries / therapy*
Anterior Cruciate Ligament Reconstruction*
Biomechanical Phenomena
Cross-Sectional Studies
Female
Gait / physiology
Hip Joint / physiopathology
Humans
Knee Joint / physiopathology*
Lower Extremity / physiopathology
Male
Middle Aged
Movement / physiology*
Physical Therapy Modalities*