Gait patterns after anterior cruciate ligament reconstruction

Clinical Orthopaedics and Related Research, 2002

The Knee, 1997

Ten subjects with symptomatic ACL deficiency and 10 normal subjects were analyzed. Gait analysis was performed by using a 3D optoelectronic system, a force platform and a telemetric electromyograph. The kinematic data were recorded from the hip, knee and ankle joints. The examined muscles were Vastus Lateralis, Rectus Femoris, Biceps Femoris and Semitendinosus. M'odifications to external moments in the sagittal plane were apparent at all examined joints. The patterns of the EMGs confirmed these results with altered activity of both flexors and extensors groups. The hip and knee joints also showed modifications to the adduction moment during the stance phase. These changes would affect the loading features of the knee structures and thus could contribute causing joint degenerative changes. Gait analysis is confirmed to be an important tool in treatment planning. 0 1997 Elsevier Science B.V.

Serbian Journal of Experimental and Clinical Research, 2012

DEVITA. P.. T. HORTOBAGYI, and I. BARRIER. Gait biomechanics are not normal after anterior cruciate ligament reconstruction and accelerated rehabilitation. . Purpose: Accelerated rehabilitation for anterior cruciate ligament (ACL) injury and reconstruction surgery is designed to return injured people to athletic activities in approximately 6 months. The small amount of empirical data on this population suggests, however, that the torque at the knee joint may not return until 29, months after surgery during walking and even longer during running. Although the rehabilitation has ended and individuals have returned to preinjury activities. gait mechanics appear to be abnormal at the end of accelerated programs. The purpose of this study was to compare lower extremity joint kinematics. kinetics, and energetics between individuals having undergone ACL reconstruction and accelerated rehabilitation and healthy individuals. Methods: Eight ACL-injured and 22 healthy subjects were tested. Injured subjects were tested 3 wk and 6 months (the end of rehabilitation) rfter surgery. Ground reaction force and kinematic data were combined with inverse dynamics to predict snginal plane joint toques and powers from which angular impulse and work were derived. Results: The difference in all kinematic variables between the two tests for the ACL group avenged 38% (all P < 0.05 ).

Acta Ortopédica Brasileira, 2016

Objective: To compare gait spatiotemporal parameters of healthy and ACL reconstructed subjects in order to classify the status of gait normality. Methods: Fourteen healthy subjects and eight patients submitted to ACL reconstruction walked along a walkway while the lower limbs movement was captured by an infrared camera system. The frames where the initial contact and toe-off took place were determined and the following dependent variables, which were compared between groups through the Mann-Whitney test (α=0.05) were calculated: percentage of time in initial double stance, percentage of time in single stance, percentage of time in terminal double stance, stride length and gait velocity. Initially, all variables were compared between groups using a Mann-Whitney test. A logistic regression was applied, including all dependent variables, to create a model that could differentiate healthy and ACL reconstructed subjects. Results: ACL reconstructed group showed no differences in any spatiotemporal parameter of gait (p > 0.05) in relation to the control group, although the angular kinematic differences of the knee remained altered, as evidenced in a study with a similar sample. Conclusion: The regression classified all subjects as healthy, including the ACL reconstructed group, suggesting the spatiotemporal variables should not be used as the sole criterion of return to sports activities at the same level as prior to injury. Level of Evidence III, Case Control Study.

http://www.journals.aiac.org.au/index.php/IJKSS/article/view/5856/4186, 2020

Background: In athletes with anterior cruciate ligament (ACL) deficiencies could assess functional capabilities with different instruments such as use of a camera in vivo situation. However, these methods have suffered from a large number of limitations such as inability to be repeatable and complexity in technique. Objective: The main purpose of this study was to compare gait pattern of the athletes with ACL injury and able-bodied subjects using an accelerometer. Method: A three-dimensional accelerometer was placed over the tibia tuberosity of 20 healthy and 20 individuals with ACL-deficiencies (ACLD). After walking on the treadmill, the principal components of the acceleration data were calculated using MATLAB software. Results: In this study, Principle Component analysis was used for statistical analysis. The results indicated that subjects with ACL deficiency have different gait pattern compared to the control group. The major differences between stride trajectories of the two groups were at the end of mid-swing and the beginning of terminal swing phases in vertical axis. ACL deficient subjects exhibited different gait patterns during mid and terminal stance phases in anterior-posterior axis compared with normal controls. Conclusions: The difference in gait between subjects with ACL deficiency and healthy subjects are depends on variation in the amount of knee flexion and tibia rotation that could be altered to motor recruitment.

BMC Musculoskeletal Disorders, 2015

Background: The goal of this study was to biomechanically assess tibial rotation in the knee joint simultaneous changes in rotation of large joints of the lower limbs and pelvis during gait in patients during early postoperative stages following anterior cruciate ligament (ACLR) reconstruction. We hypothesized that tibial rotation is associated with changes in rotation of the large joints of the lower limbs and the pelvis during gait in patients after ACLR reconstruction. Methods: The patients were divided into two groups. The ACLR group (n = 32 males) underwent primary ACLR in one leg and postoperative physiotherapy. The control group (n = 30 males) had no knee injuries. After clinical assessment in both groups, the values of kinematic parameters of foot, tibial, femoral, and pelvic rotation were measured during gait on a flat surface using the three-dimensional BTS Smart System. In the ACLR group, measurements were taken during the 4th, 9th, and 14th weeks of postoperative physiotherapy. The results of the ACLR group were compared with those of the control group. Results: During gait, between the 9th and 14th weeks following ACLR, there are normal values of foot, tibia, and pelvic rotation in the operated legs compared with results obtained from un-operated legs and the control group. Discussion: Analysis of rotations occurring only in knee joints does not reflect all of the multiarticular disorders of gait kinematics. The study also suggests that analyzing tibial rotation in the knee joint with simultaneous changes in rotation in large joints of the lower limbs provides better opportunities than singular analysis of rotation in the knee joint for the assessment of disorders in gait kinematics. Conclusions: In gait, at the maximal extension of the knee during preparation for the stance phase, external hip rotation patterns have not been fully restored 14 weeks after ACLR.

Water Science and Technology, 2008

The paper discusses the experimental optimisation of both chemical and mechanical cleaning procedures for a flat-sheet submerged membrane bioreactor fed with municipal wastewater.

Recent factory planning projects are facing severe issues, i.e. increasing cost and time pressure and higher frequency of planning projects, resulting in repeated failure to achieve the targets concerning time schedule and costs. Experience from multiple areas, such as operations research, investment planning or even everyday life, shows that heuristics have the capability to reduce the time and cost consumption of solution finding processes while maintaining a good quality of the results. Heuristics are simple techniques or "rules of thumb" which also have the potential to support the solution finding process in factory planning. Today, heuristics are applied in factory planning but the application does not follow a systematic approach. It is based on restricted time and cost budgets of individuals rather than the systematic and value-optimized assignment of scarce resources against the background of the overall project. Furthermore, the impact of heuristics on the target system of a factory planning project, consisting of quality, time schedule and project cost, has not yet been examined. This paper presents a type-oriented approach to support the systematic utilization of heuristics in factory planning. In a first step, empowering characteristics for the application of heuristics in general are identified. These findings are then transferred to the field of factory planning. The result is a morphological matrix that facilitates the classification of factory planning projects with reference to their suitability for the use of heuristic methods. Based on the matrix, several factory planning projects are examined and classified to derive reference types that indicate the potential of the successful application of heuristics.

Proteins, 2014

Advances in structural biology, such as cryo-electron microscopy (cryo-EM) have allowed for a number of sophisticated protein complexes to be characterized. However, often only a static snapshot of a protein complex is visualized despite the fact that conformational change is frequently inherent to biological function, as is the case for molecular motors. Computer simulations provide valuable insights into the different conformations available to a particular system that are not accessible using conventional structural techniques. For larger proteins and protein complexes, where a fully atomistic description would be computationally prohibitive, coarse-grained simulation techniques such as Elastic Network Modeling (ENM) are often employed, whereby each atom or group of atoms is linked by a set of springs whose properties can be customized according to the system of interest. Here we compare ENM with a recently proposed continuum model known as Fluctuating Finite Element Analysis (FF...