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Sagittal Plane Knee Translation and Electromyographic Activity During Closed and Open Kinetic Chain Exercises in Anterior Cruciate Ligament-Deficient Patients and Control Subjects
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0003-3527-5488
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Faculty of Health Sciences.
2001 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 29, no 1, 72-82 p.Article in journal (Refereed) Published
Abstract [en]

Using electrogoniometry and electromyography, we measured tibial translation and muscle activation in 12 patients with unilateral anterior cruciate ligament injury and in 12 control subjects. Measurements were made during an active extension exercise with 0-, 4-, and 8-kg weights and during squats on two legs and on one leg where the projection of the center of gravity was placed over, behind, and in front the feet. In the uninjured subjects, tibial translation increased with increasing load except during the squat with the center of gravity behind the feet, which produced the smallest translation. For the active extension exercises, translation was greater during eccentric activity. In the anterior cruciate ligament-injured knees, all squats resulted in similar translation, which was smaller than that during the active extension exercise. The highest muscle activation was seen during squats. Hamstring muscle activity was low. Increased static laxity in the anterior cruciate ligament-deficient knee can be controlled during closed but not during open kinetic chain exercises. Coactivation of the quadriceps and gastrocnemius muscles seems to be important for knee stability, whereas hamstring muscle coactivation was insignificant. To minimize sagittal translation during nonoperative management of anterior cruciate ligament-deficient knees, closed kinetic chain exercises are preferable to open kinetic chain exercises, and importance should be attached to the spontaneous coactivation of the quadriceps and gastrocnemius muscles.

Place, publisher, year, edition, pages
2001. Vol. 29, no 1, 72-82 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-27779Local ID: 12526OAI: oai:DiVA.org:liu-27779DiVA: diva2:248331
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, JoannaGillquist, Jan

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