Neuromuscular Control During Stair Descent and Artificial Tibial Translation After Acute ACL Rupture

Blasimann Schwarz, Angela; Busch, Aglaja; Henle, Philipp; Bruhn, Sven; Vissers, Dirk; Baur, Heiner (2022). Neuromuscular Control During Stair Descent and Artificial Tibial Translation After Acute ACL Rupture Orthopaedic Journal of Sports Medicine, 10(10), p. 232596712211232. Sage Publications 10.1177/23259671221123299

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Background: Anterior cruciate ligament (ACL) rupture has direct effect on passive and active knee stability and, specifically, stretch-reflex excitability. Purpose/Hypothesis: The purpose of this study was to investigate neuromuscular activity in patients with an acute ACL deficit (ACL-D group) compared with a matched control group with an intact ACL (ACL-I group) during stair descent and artificially induced anterior tibial translation. It was hypothesized that neuromuscular control would be impaired in the ACL-D group. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Surface electromyographic (EMG) activity of the vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) muscles was recorded bilaterally in 15 patients with ACL-D (mean, 13.8 days [range, 7-21 days] since injury) and 15 controls with ACL-I during stair descent and artificially induced anterior tibial translation. The movements of stair descent were divided into preactivity, weight acceptance, and push-off phases. Reflex activity during anterior tibial translation was split into preactivity and short, medium, and late latency responses. Walking on a treadmill was used for submaximal EMG normalization. Kruskal-Wallis test and post hoc analyses with Dunn-Bonferroni correction were used to compare normalized root mean square values for each muscle, limb, movement, and reflex phase between the ACL-D and ACL-I groups. Results: During the preactivity phase of stair descent, the hamstrings of the involved leg of the ACL-D group showed 33% to 51% less activity compared with the matched leg and contralateral leg of the ACL-I group (P < .05). During the weight acceptance and push-off phases, the VL revealed a significant reduction (approximately 40%) in the involved leg of the ACL-D group compared with the ACL-I group. At short latency, the BF and ST of the involved leg of the ACL-D group showed a significant increase in EMG activity compared with the uninvolved leg of the ACL-I group, by a factor of 2.2 to 4.6. Conclusion: In the acute phase after an ACL rupture, neuromuscular alterations were found mainly in the hamstrings of both limbs during stair descent and reflex activity. The potential role of prehabilitation needs to be further studied.

Item Type:	Journal Article (Original Article)
Division/Institute:	School of Health Professions School of Health Professions > Physiotherapy School of Health Professions > Physiotherapy > Neuromuscular Control
Name:	Blasimann Schwarz, Angela0000-0003-0934-8284; Busch, Aglaja0000-0001-6025-3710; Henle, Philipp; Bruhn, Sven; Vissers, Dirk and Baur, Heiner0000-0002-4780-225X
Subjects:	R Medicine > R Medicine (General)
ISSN:	2325-9671
Publisher:	Sage Publications
Language:	English
Submitter:	Dr. Angela Blasimann
Date Deposited:	14 Nov 2022 15:49
Last Modified:	14 Nov 2022 15:49
Publisher DOI:	10.1177/23259671221123299
PubMed ID:	36263309
Uncontrolled Keywords:	anterior cruciate ligament; rupture; acute; neuromuscular control; tibial translation; stairs
ARBOR DOI:	10.24451/arbor.17937
URI:	https://arbor.bfh.ch/id/eprint/17937