Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 18, Issue 6, pp 814–823

Postural orientation in subjects with anterior cruciate ligament injury: development and first evaluation of a new observational test battery



Anterior cruciate ligament (ACL) injury is associated with mechanical instability and defective neuromuscular function, and can lead to further injury, increased joint loading and osteoarthritis. Patients with ACL injury demonstrate altered postural orientation, manifested as observable “substitution patterns” (SPs) but no one has applied a clinically useful method to systematically study postural orientation in these patients. Here, we investigated the presence of such patterns in 24 adults with ACL injury and in 49 controls, in parallel with the development and a first evaluation of a new test battery, test for SPs. The rationale behind the test for SPs was to characterize postural orientation as the ability to maintain appropriate relationships between body segments and environment during weight-bearing movements. In this first study, patients displayed SPs more frequently and/or more clearly on their injured, but also their uninjured side than did controls. Inter-rater and intra-rater reproducibility was good at a group level. Future studies of validity, responsiveness and including other subgroups of patients with ACL injury will have to prove if the test for SPs can be used in the diagnostics of defective neuromuscular function following knee injury, when planning and carrying out training and rehabilitation and when deciding appropriate time to return to activity and sports after ACL injury.


Anterior cruciate ligament Postural balance Weight-bearing Task performance Analysis Motor skills Reproducibility of findings 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Department of Health Sciences, Division of Physical TherapyLund UniversityLundSweden
  2. 2.Unit for Specialized Pain Rehabilitation, Department of RehabilitationLund University HospitalLundSweden
  3. 3.Neuronano Research Center, Department of Experimental Medical ScienceLund UniversityLundSweden
  4. 4.Department of Orthopedics, Clinical SciencesLund UniversityLundSweden

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