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Do ground reaction forces during unilateral and bilateral movements exhibit compensation strategies following ACL reconstruction?

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aims of the study were (1) to evaluate the leg asymmetry assessed with ground reaction forces (GRFs) during unilateral and bilateral movements of different knee loads in anterior cruciate ligament (ACL) reconstructed patients and (2) to investigate differences in leg asymmetry depending on the International Knee Documentation Committee Subjective Form (IKDC) in order to identify potential compensation strategies.

Methods

The knee function of 50 ACL reconstructed (patella tendon) patients was examined at 31 ± 7 months after the surgery. GRFs were quantified during the sit-to-stand and stand-to-sit test, the step-up and step-down test, and the two- and one-leg vertical jump. Further, the IKDC score, the anterior–posterior knee laxity, and the concentric torque of the quadriceps and hamstring muscles were evaluated.

Results

Differences between the operated and non-operated leg were found in the knee laxity, the quadriceps torque, and GRFs. The patients with low IKDC scores demonstrated greater leg asymmetries in GRFs compared to the patients with high IKDC scores.

Conclusions

ACL reconstructed patients showed GRF asymmetries during unilateral and bilateral movements of different knee loads. Three compensation strategies were found in patients with low subjective knee function: (1) a reduced eccentric load, (2) an inter-limb compensation during bilateral movements, and (3) the avoidance of high vertical impact forces. These compensation strategies may be indicative of a protective adaptation to avoid excessive ACL strain. GRF measurements are practicable and efficient tools to identify individual compensation strategies during early rehabilitation.

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Acknowledgments

We thank K. Mießen for her help in data acquisition and the HELIOS Research Center for funding the study.

Conflict of interest

The authors declare that they have no competing interests. The study was funded by the HELIOS Research Center (ID 006745).

Author information

Authors and Affiliations

  1. Department of Movement and Training Science, University of Wuppertal, Fuhlrottstraße 10, 42119, Wuppertal, Germany

    Christian Baumgart, Matthias W. Hoppe & Jürgen Freiwald

  2. Clinic of Trauma Surgery and Orthopedics, HELIOS Klinikum Wuppertal, Heusnerstraße 40, 42283, Wuppertal, Germany

    Markus Schubert

  3. Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands

    Alli Gokeler

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  1. Christian Baumgart
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Correspondence to Christian Baumgart.

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Baumgart, C., Schubert, M., Hoppe, M.W. et al. Do ground reaction forces during unilateral and bilateral movements exhibit compensation strategies following ACL reconstruction?. Knee Surg Sports Traumatol Arthrosc 25, 1385–1394 (2017). https://doi.org/10.1007/s00167-015-3623-7

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  • DOI: https://doi.org/10.1007/s00167-015-3623-7

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