Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal study
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 ho...
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Elsevier
2025-12-01
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| Series: | Journal of Sport and Health Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2095254624001443 |
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| author | Cortney Armitano-Lago Elizabeth Bjornsen Caroline Lisee Ashley Buck Christin Büttner Adam W. Kiefer Todd A. Schwartz Brian Pietrosimone |
| author_facet | Cortney Armitano-Lago Elizabeth Bjornsen Caroline Lisee Ashley Buck Christin Büttner Adam W. Kiefer Todd A. Schwartz Brian Pietrosimone |
| author_sort | Cortney Armitano-Lago |
| collection | DOAJ |
| description | 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 within 6-month post-ACLR, which may have long-term implications for knee-joint health. |
| format | Article |
| id | doaj-art-a6dea39b631d4b79820e7042af29d157 |
| institution | Kabale University |
| issn | 2095-2546 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Sport and Health Science |
| spelling | doaj-art-a6dea39b631d4b79820e7042af29d1572025-01-16T04:28:33ZengElsevierJournal of Sport and Health Science2095-25462025-12-0114100988Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal studyCortney Armitano-Lago0Elizabeth Bjornsen1Caroline Lisee2Ashley Buck3Christin Büttner4Adam W. Kiefer5Todd A. Schwartz6Brian Pietrosimone7Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Corresponding author.Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Kinesiology, University of Georgia, Athens, GA 30602, USADepartment of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USABackground: 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 within 6-month post-ACLR, which may have long-term implications for knee-joint health.http://www.sciencedirect.com/science/article/pii/S2095254624001443Cross-recurrence quantification analysisGaitCoordinationOsteoarthritisNonlinear dynamics |
| spellingShingle | Cortney Armitano-Lago Elizabeth Bjornsen Caroline Lisee Ashley Buck Christin Büttner Adam W. Kiefer Todd A. Schwartz Brian Pietrosimone Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal study Journal of Sport and Health Science Cross-recurrence quantification analysis Gait Coordination Osteoarthritis Nonlinear dynamics |
| title | Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal study |
| title_full | Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal study |
| title_fullStr | Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal study |
| title_full_unstemmed | Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal study |
| title_short | Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal study |
| title_sort | lower limb coordination patterns following anterior cruciate ligament reconstruction a longitudinal study |
| topic | Cross-recurrence quantification analysis Gait Coordination Osteoarthritis Nonlinear dynamics |
| url | http://www.sciencedirect.com/science/article/pii/S2095254624001443 |
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