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Thigh muscle co-contraction patterns in individuals with anterior cruciate ligament reconstruction, athletes and controls during a novel double-hop test.

ABSTRACT: Efficient neuromuscular coordination of the thigh muscles is crucial in maintaining dynamic knee stability and thus reducing anterior cruciate ligament (ACL) injury/re-injury risk. This cross-sectional study measured electromyographic (EMG) thigh muscle co-contraction patterns during a novel one-leg double-hop test among individuals with ACL reconstruction (ACLR; n = 34), elite athletes (n = 22) and controls (n = 24). Participants performed a forward hop followed by a 45° unanticipated diagonal hop either in a medial (UMDH) or lateral direction (ULDH). Medial and lateral quadriceps and hamstrings EMG were recorded for one leg (injured/non-dominant). Quadriceps-to-Hamstring (Q:H) ratio, lateral and medial Q:H co-contraction indices (CCIs), and medial-to-lateral Q:H co-contraction ratio (CCR; a ratio of CCIs) were calculated for three phases (100 ms prior to landing, initial contact [IC] and deceleration phases) of landing. We found greater activity of the quadriceps than the hamstrings during the IC and deceleration phases of UMDH/ULDH across groups. However, higher co-contraction of medial rather than lateral thigh muscles during the deceleration phase of landing was found; if such co-contraction patterns cause knee adduction, a putative mechanism to decrease ACL injury risk, during the deceleration phase of landing across groups warrants further investigation.

SUBMITTER: Arumugam A

PROVIDER: S-EPMC9119948 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Thigh muscle co-contraction patterns in individuals with anterior cruciate ligament reconstruction, athletes and controls during a novel double-hop test.

Arumugam Ashokan A Häger Charlotte K CK

Scientific reports 20220519 1

Efficient neuromuscular coordination of the thigh muscles is crucial in maintaining dynamic knee stability and thus reducing anterior cruciate ligament (ACL) injury/re-injury risk. This cross-sectional study measured electromyographic (EMG) thigh muscle co-contraction patterns during a novel one-leg double-hop test among individuals with ACL reconstruction (ACLR; n = 34), elite athletes (n = 22) and controls (n = 24). Participants performed a forward hop followed by a 45° unanticipated diagonal ...[more]

PMID: 35589937

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Project description:The purpose of this work was to provide a simple method to determine reactive strength during the 6-meter timed hop test (6mTH) and evaluate its association with isokinetic peak torque in patients following anterior cruciate ligament reconstruction (ACLR). Twenty-nine ACLR patients who were at least four months from surgery were included in this analysis. Participants were brought into the laboratory on one occasion to complete functional testing. Quadriceps and hamstring isokinetic testing was completed bilaterally at 60, 180, and 300 deg∙s-1, using extension peak torque from each speed as the outcome measure. The 6mTH was completed bilaterally using a marker-based motion capture system, and reactive strength ratio (RSR) was calculated from the vertical velocity of the pelvis during the test. An adjustment in RSR was made using the velocity of the 6mTH test to account for different strategies employed across participants. Repeated measures correlations were used to determine associations among isokinetic and hop testing variables. A two-way mixed analysis of variance was used to determine differences in isokinetic and hop testing variables between operated and non-operated legs and across male and female participants. Moderate positive associations were found between RSR (and adjusted RSR) and isokinetic peak torque at all speeds (r = .527 to .577). Mean comparisons showed significant main effects for leg and sex. Patients showed significant deficits in their operated versus non-operated legs in all isokinetic and hop testing variables, yet only isokinetic peak torque and timed hop time showed significant differences across male and female groups. Preliminary results are promising but further development is needed to validate other accessible technologies available to calculate reactive strength during functional testing after ACLR. Pending these developments, the effects of movement strategies, demographics, and levels of participation on RSR can then be explored to translate this simple method to clinical environments.

Project description:BackgroundThere has been increased interest in lateral extra-articular procedures, such as anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET), to reduce anterolateral rotation instability of the knee after anterior cruciate ligament reconstruction (ACLR). Despite promising surgical outcomes with these techniques, their impact on knee strength recovery is unknown.HypothesisPatients undergoing lateral extra-articular procedures at the time of ACLR would have impaired thigh muscle strength at 6 to 9 months after surgery.Study designCohort study; Level of evidence, 3.MethodsAdolescent patients who had undergone primary unilateral ACLR with lateral extra-articular augmentation between 2017 and 2023 were identified. Patients were included if they were aged between 12 and 20 years at the time of surgery and had completed an isokinetic strength assessment at 6 to 9 months after surgery. A total of 104 participants (mean age, 16.5 ± 1.7 years; 63 female) were included in this analysis: 25 who underwent ACLR+ALLR, 17 who underwent ACLR+LET, and 62 who underwent isolated ACLR. Isokinetic knee extension and flexion strength normalized to body weight, as well as the bilateral limb symmetry index (LSI), were assessed. One-way analysis of variance and analysis of covariance were used to compare differences between surgical techniques.ResultsAfter adjusting for age, graft type, and time since surgery, the ACLR+LET (1.36 ± 0.52 N·m/kg) and ACLR+ALLR (1.61 ± 0.53 N·m/kg) groups had significantly less involved limb knee extension strength (P = .025), uninvolved limb knee extension strength (P = .046), and LSI for knee extension strength (P = .040) compared to the isolated ACLR group. There were no differences between the 3 groups regarding involved limb knee flexion strength (P = .222) or uninvolved limb knee flexion strength (P = .984), but the isolated ACLR group displayed a greater LSI for knee flexion strength (96.6% ± 17.8%; P = .012).ConclusionThe addition of lateral extra-articular procedures at the time of ACLR was associated with decreased quadriceps strength at 6 to 9 months after ACLR. While lateral extra-articular procedures may enhance knee rotary stability after ACLR, prolonged rehabilitation may be needed to re-establish adequate quadriceps strength before return to sports.

Dataset Information

Thigh muscle co-contraction patterns in individuals with anterior cruciate ligament reconstruction, athletes and controls during a novel double-hop test.

Publications

Thigh muscle co-contraction patterns in individuals with anterior cruciate ligament reconstruction, athletes and controls during a novel double-hop test.

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