Abstract

Individuals who received anterior cruciate ligament (ACL) reconstruction surgeries demonstrated lower extremity movement asymmetries. The purpose of this study was to determine if psychological impairment was a contributor to lower extremity movement asymmetries in walking for individuals who received ACL reconstruction surgeries. Three-dimensional videographic and force plate data were collected for 25 males after unilateral ACL reconstruction performing walking without (single-task condition) and with the concurrent cognitive task (dual-task condition). Both uninjured and injured legs had significantly smaller peak knee flexion angle and peak knee extension moment during loading response and mid-stance phases in dual-task condition compared to single task condition (P ≤ 0.012). Walking condition and leg had significant interaction effects on peak hip adduction angle during mid-stance phase (P = 0.042) and peak hip abduction moment during loading response phase (P = 0.048). The inter-leg difference of peak hip adduction angle during mid-stance (P = 0.038) and terminal stance (P = 0.036) phases, and peak hip abduction moment during loading response phase (P = 0.024) were significantly decreased in dual-task condition compared to single-task condition. Psychological factors have significant effects on post-operative movements of both injured and uninjured knees of individuals who received ACL reconstruction surgery. Although physical factors may be primary contributors to the post-operative lower extremity movement asymmetries, psychological factors also contribute to the post-operative hip movement asymmetries.

Highlights

  • Anterior cruciate ligament (ACL) reconstruction is a commonly surgical procedure to restore knee functions after an anterior cruciate ligament (ACL) injury[1]

  • A study on psychological changes of patients who received ACL reconstruction surgery found that patients who returned to the competitive sport at 12 months after the surgery had more positive psychological responses to sports participation at 6 and 12 months after the surgery compared to patients who had not returned to competitive sport[20]

  • These studies indicated that psychological impairments may contribute to patients’ movement asymmetries after ACL reconstruction surgery, the effect of psychological impairment on lower extremity movement asymmetries has not been confirmed yet

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Summary

Introduction

Anterior cruciate ligament (ACL) reconstruction is a commonly surgical procedure to restore knee functions after an ACL injury[1]. Lentz et al reported that despite quadriceps strength was improved from 6 months to 1 year, functional limitations remained unchanged[17] These studies indicated that quadriceps strength deficit was not the only contributor to lower extremity movement asymmetries. A study on psychological changes of patients who received ACL reconstruction surgery found that patients who returned to the competitive sport at 12 months after the surgery had more positive psychological responses to sports participation at 6 and 12 months after the surgery compared to patients who had not returned to competitive sport[20] These studies indicated that psychological impairments may contribute to patients’ movement asymmetries after ACL reconstruction surgery, the effect of psychological impairment on lower extremity movement asymmetries has not been confirmed yet

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