Movement Variability During Single Leg Drop for Individuals after Anterior Cruciate Ligament Reconstruction
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Date
2020-05
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The Ohio State University
Abstract
Individuals who undergo anterior cruciate ligament reconstruction (ACLR) often experience suboptimal post-operative outcomes such as high risk of reinjury, low levels of returning to former level of sport and increased risk of developing knee osteoarthritis. Abnormal knee motion and movement patterns have been observed following ACLR and rehabilitation, which may be the cause for these suboptimal results, and is not currently considered in return to sport criteria. The dynamic movement theory proposed that there is a preferred range for movement variability; variability that is too high can lead to instability and reduced adaptability to environmental demands while variability that is too low is accompanied by lower ranges of motion. This theory into dynamic movements has been used in gait studies post-ACLR but has not yet been used to analyze more demanding dynamic tasks, such as jumping and landing, that are commonly performed by the young, active cohort with ACL injuries. Further understanding of movement variability after ACLR during demanding tasks could provide additional insight into the suboptimal outcomes of this patient population. Therefore, the purpose of this study was to compare lower extremity movement variability during a single leg drop test between young individuals who have undergone ACLR and a control group, and secondly compare the movement variability of the injured leg to the uninjured leg for the ACLR population. Motion capture data was processed by utilizing Cortex and the exported data was analyzed in MATLAB using a vector coding technique to find the coordinative variability associated with each subject. Both the injured and uninjured leg for the ACL population showed increased movement variability several key hip, knee and ankle joint couplings when compared to controls. Our findings indicated that patients following ACLR exhibit compromised neuromuscular control during this demanding task. Comparison of the injured leg to the uninjured leg did not show significant difference which may be due to the changes to neuromuscular control in both limbs following ACLR. Further research needs to be done to determine the impact that increased movement variability has on post-ACLR functional outcome and on whether it contributes to the suboptimal outcomes seen in the ACLR population.
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Keywords
biomechanical, ACLR, movement variability, coordination