Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry

# Background Gait asymmetries after anterior cruciate ligament reconstruction (ACLR) may lead to radiographic knee osteoarthritis. Slower walking speeds have been associated with biomarkers suggesting cartilage breakdown. The relationship between walking speed and gait symmetry after ACLR is unknown...

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Autores principales:	Rachel J. Knobel, Naoaki Ito, Elanna K. Arhos, Jacob J. Capin, Thomas S. Buchanan, Lynn Snyder-Mackler
Formato:	article
Lenguaje:	EN
Publicado:	North American Sports Medicine Institute 2021
Materias:	Sports medicine RC1200-1245
Acceso en línea:	https://doaj.org/article/8a59bc64c12e46509e15574e3befdaad
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spelling	oai:doaj.org-article:8a59bc64c12e46509e15574e3befdaad2021-12-02T17:43:26ZPatients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry10.26603/001c.187102159-2896https://doaj.org/article/8a59bc64c12e46509e15574e3befdaad2021-02-01T00:00:00Zhttps://ijspt.scholasticahq.com/article/18710-patients-walking-faster-after-anterior-cruciate-ligament-reconstruction-have-more-gait-asymmetry.pdfhttps://doaj.org/toc/2159-2896# Background Gait asymmetries after anterior cruciate ligament reconstruction (ACLR) may lead to radiographic knee osteoarthritis. Slower walking speeds have been associated with biomarkers suggesting cartilage breakdown. The relationship between walking speed and gait symmetry after ACLR is unknown. # Hypothesis/Purpose To determine the relationship between self-selected walking speeds and gait symmetry in athletes after primary, unilateral ACLR. # Study Design Secondary analysis of a clinical trial. # Methods Athletes 24±8 weeks after primary ACLR walked at self-selected speeds as kinematics, kinetics, and electromyography data were collected. An EMG-driven musculoskeletal model was used to calculate peak medial compartment contact force (pMCCF). Variables of interest were peak knee flexion moment (pKFM) and angle (pKFA), knee flexion and extension (KEE) excursions, peak knee adduction moment (pKAM), and pMCCF. Univariate correlations were run for walking speed and each variable in the ACLR knee, contralateral knee, and interlimb difference (ILD). # Results Weak to moderate positive correlations were observed for walking speed and all variables of interest in the contralateral knee (Pearson’s r=.301-.505, p≤0.01). In the ACLR knee, weak positive correlations were observed for only pKFM (r=.280, p=0.02) and pKFA (r=.263, p=0.03). Weak negative correlations were found for ILDs in pKFM (r=-0.248, p=0.04), KEE (r=-.260, p=0.03), pKAM (r=-.323, p<0.01), and pMCCF (r=-.286, p=0.02). # Conclusion Those who walk faster after ACLR have more asymmetries, which are associated with the development of early OA. This data suggests that interventions that solely increase walking speed may accentuate gait symmetry in athletes early after ACLR. Gait-specific, unilateral, neuromuscular interventions for the ACLR knee may be needed to target gait asymmetries after ACLR. # Level of Evidence IIIRachel J. KnobelNaoaki ItoElanna K. ArhosJacob J. CapinThomas S. BuchananLynn Snyder-MacklerNorth American Sports Medicine InstitutearticleSports medicineRC1200-1245ENInternational Journal of Sports Physical Therapy, Vol 16, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sports medicine RC1200-1245
spellingShingle	Sports medicine RC1200-1245 Rachel J. Knobel Naoaki Ito Elanna K. Arhos Jacob J. Capin Thomas S. Buchanan Lynn Snyder-Mackler Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry
description	# Background Gait asymmetries after anterior cruciate ligament reconstruction (ACLR) may lead to radiographic knee osteoarthritis. Slower walking speeds have been associated with biomarkers suggesting cartilage breakdown. The relationship between walking speed and gait symmetry after ACLR is unknown. # Hypothesis/Purpose To determine the relationship between self-selected walking speeds and gait symmetry in athletes after primary, unilateral ACLR. # Study Design Secondary analysis of a clinical trial. # Methods Athletes 24±8 weeks after primary ACLR walked at self-selected speeds as kinematics, kinetics, and electromyography data were collected. An EMG-driven musculoskeletal model was used to calculate peak medial compartment contact force (pMCCF). Variables of interest were peak knee flexion moment (pKFM) and angle (pKFA), knee flexion and extension (KEE) excursions, peak knee adduction moment (pKAM), and pMCCF. Univariate correlations were run for walking speed and each variable in the ACLR knee, contralateral knee, and interlimb difference (ILD). # Results Weak to moderate positive correlations were observed for walking speed and all variables of interest in the contralateral knee (Pearson’s r=.301-.505, p≤0.01). In the ACLR knee, weak positive correlations were observed for only pKFM (r=.280, p=0.02) and pKFA (r=.263, p=0.03). Weak negative correlations were found for ILDs in pKFM (r=-0.248, p=0.04), KEE (r=-.260, p=0.03), pKAM (r=-.323, p<0.01), and pMCCF (r=-.286, p=0.02). # Conclusion Those who walk faster after ACLR have more asymmetries, which are associated with the development of early OA. This data suggests that interventions that solely increase walking speed may accentuate gait symmetry in athletes early after ACLR. Gait-specific, unilateral, neuromuscular interventions for the ACLR knee may be needed to target gait asymmetries after ACLR. # Level of Evidence III
format	article
author	Rachel J. Knobel Naoaki Ito Elanna K. Arhos Jacob J. Capin Thomas S. Buchanan Lynn Snyder-Mackler
author_facet	Rachel J. Knobel Naoaki Ito Elanna K. Arhos Jacob J. Capin Thomas S. Buchanan Lynn Snyder-Mackler
author_sort	Rachel J. Knobel
title	Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry
title_short	Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry
title_full	Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry
title_fullStr	Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry
title_full_unstemmed	Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry
title_sort	patients walking faster after anterior cruciate ligament reconstruction have more gait asymmetry
publisher	North American Sports Medicine Institute
publishDate	2021
url	https://doaj.org/article/8a59bc64c12e46509e15574e3befdaad
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_version_	1718379655927431168

Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry

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