Gait and plantar sensation changes following massage and textured insole application in patients after anterior cruciate ligament reconstruction |
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Affiliation: | 1. Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA;2. Laboratory of Systems Physiology, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA;1. Department of Biomedical Engineering, University of Malaya, Kuala Lumpur, Malaysia;2. Department of Biomedical Engineering, Riphah International University, Islamabad, Pakistan;3. Centre for Applied Biomechanics, University of Malaya, Malaysia;4. Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;5. The Chancellery, University of Malaysia Terengganu, Terengganu, Malaysia;1. School of Human Movement Science, Faculty of Medicine and Surgery, University of Rome ‘‘Tor Vergata’’, Rome, Italy;2. Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy;3. Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Italy;4. Department of Medicine Systems, University of Rome ‘‘Tor Vergata’’, Rome, Italy;5. Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, Rome, Italy;1. Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Rey Juan Carlos University, Madrid, Spain;2. Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain |
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Abstract: | BackgroundGait impairments following anterior cruciate ligament reconstruction (ACLR) may contribute to reinjury or future osteoarthritis development. Recently, plantar cutaneous sensation deficits have been reported post-ACLR. These sensory deficits may influence gait and represent a mechanism through which to improve gait.Research questionCan established sensory interventions change sensation and gait in patients after ACLR and compared to healthy adults?MethodsTwenty-two adults (n = 11 post-ACLR, age:20.5 ± 1.9years, body mass index[BMI]:24.5 ± 3.6 kg/m2; n = 11 healthy, age:20.7 ± 1.4years, BMI:23.3 ± 2.7 kg/m2) completed two sessions separated by 48 h. Gait and plantar cutaneous sensation were assessed pre- and post-intervention (massage or textured insoles). Gait analysis was completed using 3D motion capture at 1.4 m/s ± 5% and standard inverse dynamics analysis. Plantar cutaneous sensation was assessed using Semmes Weinstein Monofilaments with a 4−2-1 stepping algorithm at the plantar aspect of the first metatarsal head, base of the fifth metatarsal, and lateral and medial malleoli. Plantar massage was a 5-minute massage to both feet. Textured insoles (coarse grit sandpaper) were worn while walking. Biomechanical data were assessed via mixed-models, repeated measures ANOVAs and 90 % confidence intervals. Wilcoxon Signed Rank tests and Mann-Whitney U tests evaluated plantar cutaneous sensation within and between groups, respectively.ResultsKnee adduction moment was lower in the ACLR versus the contralateral limb pre-massage. The vGRF was lower during the first half of stance but greater during the second half of stance in the ACLR versus the control group post-massage. Massage improved ACLR limb sensation over the first metatarsal head (P = 0.042) and medial malleolus (P = 0.027). Textured insole application improved ACLR limb sensation over the first (P = 0.043) and fifth (P = 0.027) metatarsals and medial malleolus (P = 0.028).SignificancePlantar massage and textured insoles improved plantar cutaneous sensation in the ACLR limb. Neither intervention influenced gait. Improving plantar sensation may be beneficial for patients after ACLR; however, sensory interventions to improve gait are necessary. |
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Keywords: | ACL Walking Sensory reweighting |
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