Document Type : Full Research Paper

Authors

1 Ph.D, Biomechanics Department, Biomedical Engineering Faculty, Sahand University of Technology, Tabriz, Iran

2 Assistant Professor, Biomechanics Department, Biomedical Engineering Faculty, Sahand University of Technology, Tabriz, Iran

3 Professor, Biomechanics Department, Biomedical Engineering Faculty, Sahand University of Technology, Tabriz, Iran

Abstract




Anterior cruciate ligament (ACL) rupture is one of the most costly knee injuries, usually occurring to young athletes, often leading to functional instability, inability to return to previous levels of physical activity, and premature osteoarthritis (OA). The main function of ACL is controlling anterior tibia translation as well as axial tibia rotation. Therefore, patients with ACL deficiency (ACLD) have to use different compensatory mechanisms and kinematic changes to maintain their stability during different activities. The study aims to measure the reliability of knee kinematics and ground reaction force during stair negotiation. Fifteen participants with unilateral ACLD ascended 4-step staircase, where 8-10 reflective markers was inserted on each segment of lower extremity. Five-camera VICON system and 10-camera VICON system were used in the first and second phase of study, respectively. Intra-class correlation coefficient (ICC) and standard error of measurement (SEM) was calculated for each parameter in the knee events during stair climbing. The results showed high consistency of kinematic parameters and GRF components was handled through reliability and repeatability calculations. ICC (2,5) showed similar values in injured and healthy contralateral leg with the range of (0.59-0.98) for all knee joint rotation and GRF components.

Keywords

Main Subjects

[1]     Boden, B.P., et al., Mechanisms of anterior cruciate ligament injury. Orthopedics, 2000. 23(6): p. 573-578.
[2]     Miyasaka, K., et al., The incidence of knee ligament injuries in the general population. Am J Knee Surg, 1991. 4(1): p. 3-8.
[3]     Zabala, M.E., et al., Three-dimensional knee moments of ACL reconstructed and control subjects during gait, stair ascent, and stair descent. J Biomech, 2013. 46(3): p. 515-20.
[4]     Hall, M., C.A. Stevermer, and J.C. Gillette, Gait analysis post anterior cruciate ligament reconstruction: knee osteoarthritis perspective. Gait Posture, 2012. 36(1): p. 56-60.
[5]     Zhang, L.-Q., et al., Six degrees-of-freedom kinematics of ACL deficient knees during locomotion—compensatory mechanism. Gait & posture, 2003. 17(1): p. 34-42.
[6]     Gao, B., M.L. Cordova, and N.N. Zheng, Three-dimensional joint kinematics of ACL-deficient and ACL-reconstructed knees during stair ascent and descent. Human movement science, 2012. 31(1): p. 222-235.
[7]     Berchuck, M., et al., Gait adaptations by patients who have a deficient anterior cruciate ligament. Journal of Bone and Joint Surgery - Series A, 1990. 72(6): p. 871-877.
[8]     Bulgheroni, P., et al., Walking in anterior cruciate ligament injuries. The Knee, 1997. 4(3): p. 159-165.
[9]     Thambyah, A., P. Thiagarajan, and J.G.C. Hong, Knee joint moments during stair climbing of patients with anterior cruciate ligament deficiency. Clinical Biomechanics, 2004. 19(5): p. 489-496.
[10] Tibone, J.E., et al., Functional analysis of anterior cruciate ligament instability. The American journal of sports medicine, 1986. 14(4): p. 276-284.
[11] Dai, B., et al., Using ground reaction force to predict knee kinetic asymmetry following anterior cruciate ligament reconstruction. Scandinavian journal of medicine & science in sports, 2014. 24(6): p. 974-981.
[12] Riener, R., M. Rabuffetti, and C. Frigo, Stair ascent and descent at different inclinations. Gait & posture, 2002. 15(1): p. 32-44.
[13] Ernst, G.P., et al., Lower extremity compensations following anterior cruciate ligament reconstruction. Physical Therapy, 2000. 80(3): p. 251-60.
[14] Irrgang, J., Modern trends in anterior cruciate ligament rehabilitation: nonoperative and postoperative management. Clinics in sports medicine, 1993. 12(4): p. 797-813.
[15] Chmielewski, T.L., Asymmetrical lower extremity loading after ACL reconstruction: more than meets the eye. Journal of Orthopaedic & Sports Physical Therapy, 2011. 41(6): p. 374-376.
[16] Gardinier, E.S., et al., Gait and neuromuscular asymmetries after acute ACL rupture. Medicine and science in sports and exercise, 2012. 44(8): p. 1490.
[17] Scott, A., Falls on stairways: literature review. 2005: Health and Safety Laboratory.
[18] Pohl, M.B., C. Lloyd, and R. Ferber, Can the reliability of three-dimensional running kinematics be improved using functional joint methodology? Gait Posture, 2010. 32(4): p. 559-63.
[19] Adachi, N., et al., Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta orthopaedica Scandinavica, 2002. 73(3): p. 330-334.
[20] Zimny, M.L., M. Schutte, and E. Dabezies, Mechanoreceptors in the human anterior cruciate ligament. The Anatomical Record, 1986. 214(2): p. 204-209.
[21] Rudolph, K.S., et al., Dynamic stability in the anterior cruciate ligament deficient knee. Knee Surgery, Sports Traumatology, Arthroscopy, 2001. 9(2): p. 62-71.
[22] Kratzenstein, S., et al., Effective marker placement for functional identification of the centre of rotation at the hip. Gait & posture, 2012. 36(3): p. 482-486.
[23] Camomilla, V., et al., An optimized protocol for hip joint centre determination using the functional method. Journal of biomechanics, 2006. 39(6): p. 1096-1106.
[24] Ehrig, R.M., et al., The SCoRE residual: a quality index to assess the accuracy of joint estimations. Journal of biomechanics, 2011. 44(7): p. 1400-1404.
[25] Ehrig, R.M., et al., A survey of formal methods for determining functional joint axes. Journal of biomechanics, 2007. 40(10): p. 2150-2157.
[26] Robertson, G., et al., Research methods in biomechanics, 2E. 2013: Human Kinetics.
[27] Taylor, W., et al., Repeatability and reproducibility of OSSCA, a functional approach for assessing the kinematics of the lower limb. Gait & posture, 2010. 32(2): p. 231-236.
[28] O’Connor, C.M., et al., Automatic detection of gait events using kinematic data. Gait & posture, 2007. 25(3): p. 469-474.