TY - JOUR
T1 - The influence of task complexity on knee joint kinetics following ACL reconstruction
AU - Schroeder, Megan J.
AU - Krishnan, Chandramouli
AU - Dhaher, Yasin Y.
N1 - Funding Information:
The authors gratefully acknowledge the financial support of the Arthritis Foundation (Doctoral Dissertation Award), National Institutes of Health ( NIAMS R01 AR049837 , R01 EB019834 , U01 EB015410 ), National Science Foundation (# 0966535 / 0966742 ), and the United States Department of Defense (# DR080326 ); subject identification was aided by the use of the Northwestern Medical Enterprise Data Warehouse ( NUCATS grant UL1RR025741 ). The authors would also like to thank Brian Chilelli, Jay Kalawadia, John Paul Manalo, and Despina Kotsapouikis for assistance with patient recruitment, as well as Winston Ku and Jordan Wong for assistance with data collection.
Publisher Copyright:
© 2015 Elsevier Ltd. All rights reserved.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Background Previous research indicates that subjects with anterior cruciate ligament reconstruction exhibit abnormal knee joint movement patterns during functional activities like walking. While the sagittal plane mechanics have been studied extensively, less is known about the secondary planes, specifically with regard to more demanding tasks. This study explored the influence of task complexity on functional joint mechanics in the context of graft-specific surgeries. Methods In 25 participants (10 hamstring tendon graft, 6 patellar tendon graft, 9 matched controls), three-dimensional joint torques were calculated using a standard inverse dynamics approach during level walking and stair descent. The stair descent task was separated into two functionally different sub-tasks - step-to-floor and step-to-step. The differences in external knee moment profiles were compared between groups; paired differences between the reconstructed and non-reconstructed knees were also assessed. Findings The reconstructed knees, irrespective of graft type, typically exhibited significantly lower peak knee flexion moments compared to control knees during stair descent, with the differences more pronounced in the step-to-step task. Frontal plane adduction torque deficits were graft specific and limited to the hamstring tendon knees during the step-to-step task. Internal rotation torque deficits were also primarily limited to the hamstring tendon graft group during stair descent. Collectively, these results suggest that task complexity was a primary driver of differences in joint mechanics between anterior cruciate ligament reconstructed individuals and controls, and such differences were more pronounced in individuals with hamstring tendon grafts. Interpretation The mechanical environment experienced in the cartilage during repetitive, cyclical tasks such as walking and other activities of daily living has been argued to contribute to the development of degenerative changes to the joint and ultimately osteoarthritis. Given the task-specific and graft-specific differences in joint mechanics detected in this study, care should be taken during the rehabilitation process to mitigate these changes.
AB - Background Previous research indicates that subjects with anterior cruciate ligament reconstruction exhibit abnormal knee joint movement patterns during functional activities like walking. While the sagittal plane mechanics have been studied extensively, less is known about the secondary planes, specifically with regard to more demanding tasks. This study explored the influence of task complexity on functional joint mechanics in the context of graft-specific surgeries. Methods In 25 participants (10 hamstring tendon graft, 6 patellar tendon graft, 9 matched controls), three-dimensional joint torques were calculated using a standard inverse dynamics approach during level walking and stair descent. The stair descent task was separated into two functionally different sub-tasks - step-to-floor and step-to-step. The differences in external knee moment profiles were compared between groups; paired differences between the reconstructed and non-reconstructed knees were also assessed. Findings The reconstructed knees, irrespective of graft type, typically exhibited significantly lower peak knee flexion moments compared to control knees during stair descent, with the differences more pronounced in the step-to-step task. Frontal plane adduction torque deficits were graft specific and limited to the hamstring tendon knees during the step-to-step task. Internal rotation torque deficits were also primarily limited to the hamstring tendon graft group during stair descent. Collectively, these results suggest that task complexity was a primary driver of differences in joint mechanics between anterior cruciate ligament reconstructed individuals and controls, and such differences were more pronounced in individuals with hamstring tendon grafts. Interpretation The mechanical environment experienced in the cartilage during repetitive, cyclical tasks such as walking and other activities of daily living has been argued to contribute to the development of degenerative changes to the joint and ultimately osteoarthritis. Given the task-specific and graft-specific differences in joint mechanics detected in this study, care should be taken during the rehabilitation process to mitigate these changes.
KW - ACL reconstruction
KW - Gait
KW - Joint torques
KW - Knee
KW - Motion analysis
KW - Stair descent
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U2 - 10.1016/j.clinbiomech.2015.06.003
DO - 10.1016/j.clinbiomech.2015.06.003
M3 - Article
C2 - 26101055
AN - SCOPUS:84941420963
SN - 0268-0033
VL - 30
SP - 852
EP - 859
JO - Clinical Biomechanics
JF - Clinical Biomechanics
IS - 8
ER -