Christopher V Nagelli1, Samuel C Wordeman2, Stephanie Di Stasi2,3, Joshua Hoffman2, Tiffany Marulli2,3, Timothy E Hewett1,4,5,6. 1. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota. 2. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio. 3. Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State, Columbus, Ohio. 4. Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota. 5. Sports Medicine Center, Mayo Clinic, Rochester, Minnesota; and. 6. Department of Biomedical Engineering and Physiology, Mayo Clinic, Rochester, Minnesota.
Abstract
OBJECTIVE: Athletes who return to sport after anterior cruciate ligament reconstruction (ACLR) demonstrate persistent biomechanical and neuromuscular deficits of the knee. There is limited evidence on what effect a neuromuscular training (NMT) program has on knee biomechanics in a cohort of athletes with ACLR. Therefore, the primary aim of this study was to quantify the effect of an NMT program on knee biomechanics in a cohort of ACLR athletes. Second, the post-training knee biomechanics were compared between the cohort of ACLR and control athletes. DESIGN: Cohort study. SETTING: Controlled laboratory setting. PARTICIPANTS: Eighteen athletes with ACLR and 10 control athletes. INTERVENTIONS: Neuromuscular training. MAIN OUTCOME MEASURES: Knee kinematics and kinetics during a double-limb jump-landing task. RESULTS: There were no significant interactions (P > 0.05) observed for the athletes with ACLR. However, there was a significant main effect of biomechanics testing session (P < 0.05) for knee flexion angle and moments; athletes with ACLR demonstrated greater knee flexion angle and lower knee flexion moment during the post-training biomechanics testing session. Post-training comparison between the ACLR and control athletes demonstrated no significant interactions (P > 0.05) between the groups. There was a significant main effect of group (P < 0.05) for knee frontal angle, as athletes with ACLR landed with greater knee adduction than the control athletes. CONCLUSIONS: Significant improvements in knee sagittal plane biomechanical measures were observed after the NMT program by the athletes with ACLR. In addition, post-training comparison of the ACLR and control groups demonstrates comparable knee biomechanics.
OBJECTIVE: Athletes who return to sport after anterior cruciate ligament reconstruction (ACLR) demonstrate persistent biomechanical and neuromuscular deficits of the knee. There is limited evidence on what effect a neuromuscular training (NMT) program has on knee biomechanics in a cohort of athletes with ACLR. Therefore, the primary aim of this study was to quantify the effect of an NMT program on knee biomechanics in a cohort of ACLR athletes. Second, the post-training knee biomechanics were compared between the cohort of ACLR and control athletes. DESIGN: Cohort study. SETTING: Controlled laboratory setting. PARTICIPANTS: Eighteen athletes with ACLR and 10 control athletes. INTERVENTIONS: Neuromuscular training. MAIN OUTCOME MEASURES: Knee kinematics and kinetics during a double-limb jump-landing task. RESULTS: There were no significant interactions (P > 0.05) observed for the athletes with ACLR. However, there was a significant main effect of biomechanics testing session (P < 0.05) for knee flexion angle and moments; athletes with ACLR demonstrated greater knee flexion angle and lower knee flexion moment during the post-training biomechanics testing session. Post-training comparison between the ACLR and control athletes demonstrated no significant interactions (P > 0.05) between the groups. There was a significant main effect of group (P < 0.05) for knee frontal angle, as athletes with ACLR landed with greater knee adduction than the control athletes. CONCLUSIONS: Significant improvements in knee sagittal plane biomechanical measures were observed after the NMT program by the athletes with ACLR. In addition, post-training comparison of the ACLR and control groups demonstrates comparable knee biomechanics.
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