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Anterior tibial translation during different isokinetic quadriceps torque in anterior cruciate ligament deficient and nonimpaired individuals
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Department of Neuroscience and Locomotion. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0003-3527-5488
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Department of Neuroscience and Locomotion. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Department of Neuroscience and Locomotion. Linköping University, Faculty of Health Sciences.
2001 (English)In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 31, no 1, 4-15 p.Article in journal (Refereed) Published
Abstract [en]

Study Design: Factorial quasi-experimental design.

Objectives: To quantify the effect of different levels of isokinetic concentric and eccentric knee extensor torques on the anterior tibial translation in subjects with anterior cruciate ligament (ACL) deficiency. Electromyogram (EMG) activity of 4 leg muscles was recorded in order to detect any co-activation of extensors and flexors.

Background: The rehabilitation after an ACL injury is of importance for the functional outcome of the patient. In order to construct a rehabilitation program after that injury, it is important to understand the in vivo relationships between muscle force and tibial translation.

Methods and Measures: Twelve patients with unilateral ACL injury and 11 uninjured volunteers performed 36 repetitions of a quadriceps contraction at different isokinetic concentric and eccentric torque levels, on a KinCom machine (60°•s-1), with simultaneous recordings of tibial translation (CA-4000) and EMG activity from quadriceps and hamstrings muscles. Tibial translations and EMG levels were normalized to the maximum of each subject.

Results: The individual anterior tibial translation increased with increased quadriceps torque in a similar manner in both quadriceps contraction modes in all legs tested. During concentric mode, translation was similar in all groups, but during eccentric mode, the mean translation was 38% larger in the ACL injured knees. No quadriceps-hamstrings co-activation occurred in any test or group.

Conclusions: An ACL deficient knee can limit the translation within a normal space during concentric muscle activity but not during eccentric activity. That limitation depends on other mechanisms than hamstrings co-activation.

Place, publisher, year, edition, pages
2001. Vol. 31, no 1, 4-15 p.
Keyword [en]
concentric contraction, eccentric contraction, knee kinematics, rehabilitation
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-27776Scopus ID: 11204794Local ID: 12523OAI: oai:DiVA.org:liu-27776DiVA: diva2:248328
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Sagittal plane knee motion during activity in the anterior cruciate ligament deficient knee
Open this publication in new window or tab >>Sagittal plane knee motion during activity in the anterior cruciate ligament deficient knee
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A complete rupture of the anterior cruciate ligament (ACL) results in static and often in functional instability. After an ACL-injury, most patients have to decrease their activity level, while some can cope with their injury and manage to keep a high activity level. A better tmderstanding of the influence of muscle activation and external load on the non-injured and injured knee, but also of the adaptive motion strategies employed by the patients with an unstable knee, is of importance for the construction of rehabilitation programs.

The general purpose of this thesis was to study certain knee motions during activities focused on rehabilitation, in individuals with anterior cmciate ligament injury and uninjured controls. The sagittal tibial translation and knee flexion angle were registered during motion with the CA-4000 computerized electrogoniometer and EMG was used for analysis of muscle activity. The injured knee had increased static laxity compared to the contralateral non-injured knee and the non-impaired group.

The amount of tibial translation increased with increased quadriceps torque during nonweight bearing activities (isokinetic and isotonic contractions). In the non-injured knees, the restraining mechanism was engaged above 50% of isokinetic concentric quadriceps torque and during the eccentric contractions already at low quadriceps torques (<10% of maximum). The motion pattern was similar in the injured knees and the amount of individual translation was larger during the eccentric contractions, compared to the non-injured knees.

During weight bearing, tibia translated anteriorly and remained in that position. In the non-injured knee, different loads and performance of weight bearing activities produced different amount of translation. Level walking and squat with the center of gravity behind the feet produced somewhat smaller amount of translations, while other weight bearing activities produced similar amount of translation compared to the non-weight bearing isotonic knee extension. In the injured knee, all weight bearing activities produced similar amount of translation, smaller compared to the non-weight bearing isotonic knee extension.

Quadriceps - hamstrings co-activation was not present during non-weight bearing quadriceps dominant activities and therefore, it was not shown to be a factor limiting anterior tibial translation. Also, during the weight bearing activities, hamstrings eo-contraction could not limit the anterior tibial translation. Quadriceps and gastrocnemius seems to work synergistically to stabilize the knee by maintaining an anterior position of tibia.

In the injured knee, isokinetic concentric quadriceps contraction below 50% of maximum torque produced the smallest amount of tibial translation. Weight bearing exercises produced similar ammmt of translation despite of load and performance, indicating that when level walking is allowed after an injury, other weight bearing activities can be performed without increasing the amount of translation. Eccentric isokinetic quadriceps contractions above 50% of maximum torque and isotonic quadriceps exercise with and without weights at flexion angles less that 40°, should be avoided in order protect the knee joint.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. 76 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 645
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28052 (URN)12815 (Local ID)91-7219-746-3 (ISBN)12815 (Archive number)12815 (OAI)
Public defence
2000-10-27, Berzeliussalen, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2015-03-24Bibliographically approved

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Kvist, JoannaKarlberg, ChristianGerdle, BjörnGillquist, Jan

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