Altered postural sway persists after anterior cruciate ligament reconstruction and return to sport |
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| Authors: | Mark V Paterno Laura C Schmitt Kevin R Ford Mitchell J Rauh Timothy E Hewett |
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| Institution: | 1. Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, United States;2. Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH, United States;3. Division of Occupational Therapy and Physical Therapy, Cincinnati, OH, United States;4. Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States;5. Graduate Program in Orthopaedic & Sports Sciences, Rocky Mountain University of Health Professions, Provo, UT, United States;6. Division of Physical Therapy, High Point University, High Point, NC, United States;7. Division of Physical Therapy, San Diego State University, San Diego, CA, United States;8. Department of Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, United States;9. Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, United States;10. Department of Rehabilitation Sciences, University of Cincinnati, Cincinnati, OH, United States;11. Department of Physical Therapy, Ohio State University, Columbus, OH, United States;12. The Ohio State University, Columbus, OH, United States;1. Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Japan;2. Japan Society for the Promotion of Science, Japan;1. Department of Physiotherapy, La Trobe University, Australia;2. Department of Rural Human Biosciences, La Trobe University, Australia;1. Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, NE, USA;2. College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA;1. Department of Mechanical Science and Engineering, University of Illinois, Urbana, IL, United States;2. Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, United States;3. Illinois Neurological Institute, University of Illinois College of Medicine, Peoria, IL, United States;1. Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK;2. Department of Child Health, University of Glasgow, UK;3. School of Science and Health, University of Western Sydney, Sydney, NSW, Australia;1. School of Lifelong Sport, Hokusho University, Japan;2. School of Lifelong Support Systems, Hokusho University, Japan |
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| Abstract: | Postural sway is defined as the movement of a body's center of mass within the base of support to maintain postural equilibrium. Deficits in postural sway are present after ACL injury; however, current evidence linking it to future injury risk is unclear. The purpose of this study was to determine if postural sway deficits persist after ACL reconstruction (ACLR). The hypothesis tested was that after ACLR, patients who return to sport (RTS) would demonstrate differences in postural sway compared to control (CTRL) subjects. Fifty-six subjects with unilateral ACLR released to RTS, and 42 uninjured CTRL subjects participated. Dynamic postural sway was assessed and 3-way (2 × 2 × 2) ANOVA was used to analyze the variables. A side × group × sex (p = 0.044) interaction in postural sway was observed. A side × group analysis also revealed an interaction (p = 0.04) however, no effect of sex was observed (p = 0.23). Analysis within the ACLR cohort showed less (p = 0.001) postural sway on the involved side (1.82 ± 0.84°) versus the uninvolved side (2.07 ± 0.96°). No side-to-side differences (p = 0.73) were observed in the CTRL group. The involved limb of subjects after ACLR demonstrated the least postural sway. In conclusion, these findings indicate that dynamic postural sway may be significantly altered in a population of athletes after ACLR and RTS compared to CTRL subjects. Further investigation is needed to determine if deficits in postural sway can be used as an effective criterion to assist in the decision to safely RTS after ACLR. |
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