ABSTRACT
Purpose: Postural instability and decreased balance control ability have been observed in patients after anterior cruciate ligament (ACL) reconstruction. Herein, we examined the abnormal balance control mechanisms of these patients during dynamic reaching forward and quiet standing, providing a quantitative index for rehabilitation assessment. Methods: We enrolled ACL reconstruction patients 6-8 months after surgery, and 14 gender- and age-matched healthy volunteers. The IKDC and Lysholm were applied in each patient after ACL reconstruction. All participants conducted the quiet standing and reaching forward (RF) tests at the specified locations on force plates. The ground reaction force, center of pressure (COP), and kinematics signals were recorded. The maximal reach distance (MRD), speed of RF, length of COP, peak speed of COP in anterior-posterior direction (AP-COP), and weight bearing ratio (WBR) of the affected limb were calculated in the RF test. The COP speed, COP amplitude, frequency components of COP and WBR were extracted during quiet standing. Results: We observed that the speed of RF in the patients after ACL reconstruction was significantly lower than that of controls (p < 0.05). The COP length during RF was positively correlated with the Lysholm scale in the affected limb of patients (r = 0.604, p < 0.05). The peak of AP-COP speed during RF in the affected limb of patients was significantly lower than that of the healthy controls (p < 0.05), and positively correlated with the IKDC scale (r = 0.651, p < 0.05). WBR on the affected limb of patients during RF were significantly lower than that of controls (p < 0.05). The mean (r = -0.633, p < 0.05) and peak (r = -0.643, p < 0.05) speeds of COP during quiet standing were negatively correlated with the IKDC scale value. The amplitude of AP-COP on the contralateral side of patients was significantly higher than that of controls during quiet standing (p < 0.05). Conclusion: Patients after ACL reconstruction performed decreased postural control capacity, especially in dynamic balance, and were accompanied by deficiencies in proprioception. The COP length, peak speed of COP during RF and COP speed during quiet standing could be considered as quantitative index of balance function assessment after ACL reconstruction.
ABSTRACT
This study aimed to investigate lower-limb muscle activities in gait phases and co-contraction of one gait cycle in patients with lumbar disc herniation (LDH). This study enrolled 17 LDH patients and 17 sex- and age-matched healthy individuals. Bilateral muscle activities of the rectus femoris (RF), biceps femoris long head (BL), tibialis anterior (TA), and lateral gastrocnemius (LG) during walking were recorded. The gait cycle was divided into four phases by the heel strike and top off according to the kinematics tracks. Root mean square (RMS), mean frequency (MF), and co-contraction of surface electromyography signals were calculated. The LDH patients showed enhanced BL RMS during the single support phase (SS), second double support phase, and swing phase (SW) as well as decreased MF of RF during SS and of TA and LG during SW (p < 0.05). The co-contraction of the TA-LG was increased in LDH patients than in the control group (p < 0.05). Positive correlations were observed between TA-LG co-contraction (affected side, r = 0.557, p = 0.020; contralateral side, r = 0.627, p = 0.007) and the Oswestry disability index scores in LDH patients. LDH patients have increased BL firing rate and insufficient motor unit recruitment in specific phases in the lower limbs during walking. Dysfunction in LDH patients was associated with immoderate intermuscular co-contraction of the TA-LG during walking.