Neuromuscular and biomechanical landing alterations persist in athletes returning to sport after anterior cruciate ligament reconstruction |
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| Affiliation: | 1. Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia;2. Emory Sport Performance and Research Center, USA;3. Emory Sports Medicine Center, USA;4. Department of Orthopaedics, Emory University School of Medicine, USA;5. The Micheli Center for Sports Injury Prevention, USA;6. Hewett Global Consulting, USA;7. The Rocky Mountain Consortium for Sports Research, USA;8. Department of Physical Therapy, Congdon School of Health Sciences, High Point University, USA;1. College of Arts and Sciences, The Ohio State University, Columbus, OH, USA;2. Department of Physical Therapy, Center for Exercise Medicine, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA;3. School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA;4. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA;5. Division of Sports Medicine, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;6. Division of Occupational Therapy and Physical Therapy, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;7. Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA;8. Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA |
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| Abstract: | BackgroundAnterior cruciate ligament reconstructed (ACLR) athletes show increased hamstrings activation and decreased knee flexion moments (KFMs) during single leg landing tasks at time of return-to-sport (RTS). Although these landing alterations seem protective in the short term, they might become undesirable if they persist after RTS. Therefore, the main aim of this study was to investigate whether those landing alterations persist in the months following RTS.MethodsSixteen athletes who had an ACLR performed five unilateral landing tasks at three different time points (at RTS, and at 3 and 6 months after RTS) while KFMs and hamstrings activation were recorded. The following clinical parameters were registered: isokinetic strength of quadriceps and hamstrings, ACL return-to-sport after injury scale (ACL-RSI), Tampa scale of kinesiophobia, self-reported instability and single leg hop distance. A one-way repeated measures analysis of variance (ANOVA) was used to assess whether landing deficits changed over time. Additionally, an explorative analysis was performed to assess whether those athletes whose deficits persisted the most could be identified based on baseline clinical parameters.ResultsThe ANOVA showed no differences in landing deficits between sessions, indicating persisting reduced KFMs and increased hamstrings activation in the injured leg compared with the contralateral leg. A significant improvement of the quadriceps concentric strength (at 120°/s), ACL-RSI score and jump distance of the single leg hop was found over time.ConclusionsLanding alterations were not resolved 6 months after RTS. Additional interventions may be needed to normalize landing alterations prior to return to sport. |
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| Keywords: | ACL Return-to-sport Follow up Neuromuscular control Landing kinetics |
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