Walking Ground Reaction Force Post-ACL Reconstruction: Analysis of Time and Symptoms

Purpose The association between lower-extremity loading and clinically-relevant knee symptoms at different time points following anterior cruciate ligament reconstruction (ACLR) is unclear. Vertical ground reaction force (vGRF) from walking was compared between individuals with and without clinically-relevant knee symptoms in three cohorts: 24 months post-ACLR. Methods 128 individuals with unilateral ACLR were classified as symptomatic or asymptomatic, based on previously-defined cutoff values for the Knee Osteoarthritis and Injury Outcome Score (24 months post-ACLR [symptomatic n=13, asymptomatic n=33]). vGRF exerted on the ACLR limb was collected during walking gait, and functional analyses of variance were used to evaluate the effects of symptoms and time post-ACLR on vGRF throughout stance phase (α=0.05). Results Symptomatic individuals, 24 months post-ACLR, exhibited greater vGRF during both peaks, but lesser vGRF during midstance, compared to asymptomatic individuals. Conclusion Relative to asymptomatic individuals, symptomatic individuals are more likely to underload the ACLR limb early following ACLR (i.e., 24 months). We propose these differences in lower extremity loading during walking might have implications for long-term knee health, and should be considered when designing therapeutic interventions for individuals with an ACLR. Corresponding Author: Brian Pietrosimone PhD, Associate Professor, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 210 South Road Fetzer Hall, Chapel Hill, NC 27599, Phone: 919-962-3617, Email: brian@unc.edu The results of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. The results of the present study do not constitute endorsement by ACSM. None of the authors involved with the current study have any competing interests related to the current project. The research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (1R03AR066840-01A1), the United States Army (MR140103), North Carolina Translational and Clinical Sciences (TraCS) Institute and National Athletic Trainers Association Research and Education Foundation (14NewInv001). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, TraCS Institute or the National Athletic Trainers Association Research and Education Foundation. © 2018 American College of Sports Medicine

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