Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 18, Issue 1, pp 106–114 | Cite as

Adaptations of gait and muscle activation in chronic ACL deficiency

  • Maria Lindström
  • Li Felländer-Tsai
  • Torsten Wredmark
  • Marketta Henriksson


The purpose was to investigate whether deviations in gait parameters or muscular activity patterns can be detected in the injured and healthy leg of chronic ACL-deficient subjects. Sixteen medium-level active chronic ACL-deficient patients classified as “copers” (injury duration: 12–240 months, age 17–52 years) and 15 healthy subjects (age 20–33 years) walked at self-selected speed along a 10-m runway with a level force-plate. Gait specific data, ground reaction forces, knee and ankle angles, and EMG were documented. Knee laxity was increased and the functional scores (Lysholm, KOOS) decreased in the ACL- deficient subjects, whereas the Tegner activity level score was normal. Gait speed, stride length and stance time did not differ between ACL-deficient subjects and controls. Ground reaction forces (magnitude and times), as well as knee and ankle angles at selected points during stance and swing phases were normal in the ACL-deficient subjects compared to controls. The total duration of m. tibialis anterior (TA) activity was longer in ACL-deficient subjects than in controls (ACL-deficient injured leg vs. controls, P < 0.05). In addition, the onset of lateral gastrocnemius (LG) muscle activity occurred earlier in ACL-deficient patients (P < 0.03), resulting in a TA-LG cocontraction in the ACL-deficient but not in the control group. In conclusion, chronic, medium-level active ACL-deficient patients showed abnormalities in muscular activity patterns during gait compared to control subjects, whereas there were no detectable changes in ground reaction forces and 3D kinematic data. As the aberrant muscular activity pattern may be of importance for an even gait, it is proposed that EMG recordings may give additional information in the evaluation and rehabilitation of gait when the ACL is absent.


ACL Forces Gait analysis EMG Rehabilitation 



The authors wish to thank Ingmarie Apel for the assistance in collecting the 3D kinematic data.

Competing interests

The authors declare that they have no competing interests. The study was fully supported by research grants from Karolinska Institutet and The Center for Caring Sciences (Centrum för Vårdvetenskap) in Stockholm, Sweden.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Maria Lindström
    • 1
  • Li Felländer-Tsai
    • 1
  • Torsten Wredmark
    • 1
  • Marketta Henriksson
    • 2
    • 3
  1. 1.Department of Clinical Science, Intervention and Technology (CLINTEC) K 54, Division of OrthopedicsKarolinska Institutet, HuddingeStockholmSweden
  2. 2.Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
  3. 3.Department of Physiology and PharmacologyKarolinska InstitutetStockholmSweden

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