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Knee muscle activity during gait in patients with anterior cruciate ligament injury: a systematic review of electromyographic studies

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

Abstract

Purpose

This review compared knee muscle activity between ACL-deficient (ACLD) patients and healthy controls during gait, to find out whether the available electromyography (EMG) studies support Quadriceps (Q-ceps) inhibition or hamstring facilitation during gait in ACLD patients.

Method

A systematic review was conducted to retrieve the EMG studies of knee muscles during gait in ACLD patients. Cochrane library, PubMed, Medline, Ovid, CINAHL and Science Direct databases were searched entries from 1995 through October 2014 using the terms “anterior cruciate ligament” OR “ACL”, “electromyography” Or “EMG” “gait” Or “walking”. Articles that assessed subjects with ACL rupture that used surface EMG to assess the knee muscle activity were included. The quality of the included papers was assessed using the Critical Appraisal Skills Programme tool for observational studies.

Result

In total, 13 studies met the inclusion criteria. Seven studies consistently found no significant difference in magnitude of activity or timing of Q-ceps muscle between the chronic ACLD patients and control subjects. Two studies on acute ACLD patients and three studies on ACLD patients with unstable knee found the significantly reduced Q-ceps activity compared to control subjects. Six studies showed the significantly greater hamstring activity, and three studies found prolonged duration of activity in ACLD patients compared to the control subjects.

Conclusion

This review highlighted that the results of the studies are in favour of increased hamstring muscular activity. However, decreased Q-ceps activation exists in the acute stage and in ACLD patients that experience knee instability (non-copers).

Level of evidence

III.

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Authors and Affiliations

  1. Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Sanaz Shanbehzadeh & Fatemeh Ehsani

  2. University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan

    Mohammad Ali Mohseni Bandpei

  3. Iranian Research Centre on Aging, Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Koodakyar Alley, daneshjoo Blv, Tehran, Iran

    Mohammad Ali Mohseni Bandpei

  4. Neuromuscular Rehabilitation Research Centre, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, Iran

    Fatemeh Ehsani

Authors
  1. Sanaz Shanbehzadeh
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  2. Mohammad Ali Mohseni Bandpei
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  3. Fatemeh Ehsani
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Correspondence to Mohammad Ali Mohseni Bandpei.

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Shanbehzadeh, S., Mohseni Bandpei, M. & Ehsani, F. Knee muscle activity during gait in patients with anterior cruciate ligament injury: a systematic review of electromyographic studies. Knee Surg Sports Traumatol Arthrosc 25, 1432–1442 (2017). https://doi.org/10.1007/s00167-015-3925-9

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  • DOI: https://doi.org/10.1007/s00167-015-3925-9

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