Walking gait asymmetries 6 months following anterior cruciate ligament reconstruction predict 12-month patient-reported outcomes.

Autor: Pietrosimone B; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Blackburn JT; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.; Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Padua DA; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.; Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Pfeiffer SJ; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Davis HC; Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Luc-Harkey BA; Department of Orthopedic Surgery, Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, Massachusetts., Harkey MS; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts., Stanley Pietrosimone L; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Frank BS; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Creighton RA; Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Kamath GM; Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Spang JT; Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2018 Nov; Vol. 36 (11), pp. 2932-2940. Date of Electronic Publication: 2018 Jul 13.
DOI: 10.1002/jor.24056
Abstrakt: The study sought to determine the association between gait biomechanics (vertical ground reaction force [vGRF], vGRF loading rate [vGRF-LR]) collected 6 months following anterior cruciate ligament reconstruction (ACLR) with patient-reported outcomes at 12 months following ACLR. Walking gait biomechanics and all subsections of the Knee Injury and Osteoarthritis Outcomes Score (KOOS) were collected at 6 and 12 months following ACLR, respectively, in 25 individuals with a unilateral ACLR. Peak vGRF and peak instantaneous vGRF-LR were extracted from the first 50% of the stance phase. Limb symmetry indices (LSI) were used to normalize outcomes in the ACLR limb to that of the uninjured limb (ACLR/uninjured). Linear regression analyses were used to determine associations between biomechanical outcomes and KOOS while accounting for walking speed. Receiver operator characteristic curves were used to determine the accuracy of 6-month biomechanical outcomes for identifying individuals with acceptable patient-reported outcomes, using previously defined KOOS cut-off scores, 12 months post-ACLR. Individuals with lower peak vGRF LSI 6 months post-ACLR demonstrated worse patient-reported outcomes (KOOS Pain, Activities of Daily life, Sport and Recreation, Quality of Life) at the 12-month exam. A peak vGRF LSI ≥0.99 6 months following ACLR associated with 13.33× higher odds of reporting acceptable patient-reported outcomes 12 months post-ACLR. Lesser peak vGRF LSI during walking at 6-months post-ACLR may be a critical indicator of worse future patient-reported outcomes. Clinical significance achieving early symmetrical lower extremity loading and minimizing under-loading of the ACLR limb during walking may be a potential therapeutic target for improving patient-reported outcomes post-ACLR. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2932-2940, 2018.
(© 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.)
Databáze: MEDLINE
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