Could the anterior cruciate ligament reconstruction and pronated feet affect the plantar pressure variables and muscular activity during running? A comparative study

Abstract

The unilateral anterior cruciate ligament reconstruction can create asymmetry in vertical ground reaction force and muscle activities, which could be amplified by pronated feet. The study compared plantar pressure variables, amplitude, and muscular frequency in individuals with pronated feet and anterior cruciate ligament reconstruction (PF/ACLR) versus control during running. As part of a cross-sectional study, 15 individuals with PF/ACLR (aged 23.2 ± 4.5 years) and 15 healthy control participants (aged 22.9 ± 4.1 years) ran barefoot at a speed of 3.3 m/s±5% on an 18-m runway. During running, a foot scan and electromyography systems were used to record the peak plantar pressure variables and electromyography activity of the main lower limb muscles, respectively. Results demonstrated lower peak plantar pressure values at the Toe 1 region (p < 0.001, d = 1.83) for the PF/ACLR group. The PF/ACLR group had larger peak plantar pressure values at toes second to fifth (p = 0.013, d = 1.15), fourth (p = 0.026, d = 0.97), fifth (p < 0.001, d = 1.74) metatarsal, and medial (p = 0.002, d = 1.41), and lateral (p = 0.001, d = 1.51) heel regions. The PF/ACLR group presented larger tibialis anterior (p = 0.003, d = 1.15), vastus lateralis (p = 0.001, d = 1.27), and gluteus medius (p = 0.009, d = 0.60) amplitude at the loading phase. At the mid-stance phase, larger tibialis anterior (p = 0.039, d = 0.99) and vastus lateralis (p = 0.00.024, d = 1.52) amplitudes were observed. For the push-off phase, the PF/ACLR group presented larger vastus medialis (p = 0.037, d = 0.82), biceps femoris (p = 0.004, d = 1.14), and semitendinosus (p = 0.001, d = 0.96) amplitudes. Our results demonstrated that pronated feet and anterior cruciate ligament reconstruction significantly impact plantar pressure variables and muscular amplitude in the lower limb during running.