title: Analysis of three-dimensional knee kinematics during stair descent two decades post-ACL rupture - Data revisited using statistical parametric mapping.
abstract: Changes in movement patterns following knee injuries have generally used analyses of pre-defined discrete event-related variables, whereas Statistical Parametric Mapping (SPM) assesses continuous data over time. We applied SPM to test differences for knee trajectories during stair descent between participants with past anterior cruciate ligament (ACL) rupture who underwent reconstruction or only physical therapy compared to healthy controls. Three-dimensional knee joint kinematics during stair descent were registered for 31 subjects with ACL reconstruction (ACLR), 36 subjects with ACL rupture managed with physical therapy only (ACLPT) (∼23years post-injury), and 32 uninjured controls. SPM was used to assess differences between groups for the entire three-component knee trajectory. A significant difference between the three groups was found for the first ∼10% of stance phase. Post-hoc analyses showed between-group differences when comparing the ACLPTto the control groups. Analyses of ACLPTversus control groups for individual vector components suggested a combination of less flexion at initial foot contact, and less adduction during weight acceptance (∼40% of stance). Altered knee kinematics were confirmed during weight acceptance of stair descent for the ACLPTgroup compared to controls, but not for ACLRgroup. Further exploration of the use of SPM and agreement with clinical gait assessment is warranted.
authors.affiliation: Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Box 56, Dunedin 9056, New Zealand. Electronic address: gisela.sole@otago.ac.nz.
authors.forename: Gisela
authors.initials: G
authors.lastname: Sole
authors.affiliation: Institute of Fiber Engineering, Department of Bioengineering, Shinshu University, Tokida 3-15-1, Ueda, Nagano 386-8567, Japan. Electronic address: pataky@shinshu-u.ac.jp.
authors.forename: Todd
authors.initials: T
authors.lastname: Pataky
authors.affiliation: Institute of Fiber Engineering, Department of Bioengineering, Shinshu University, Tokida 3-15-1, Ueda, Nagano 386-8567, Japan. Electronic address: eva.tengman@umu.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Tengman
authors.affiliation: Dept. of Community Medicine and Rehabilitation, Section for Physical Therapy, Umeå University, SE-90187 Umeå, Sweden. Electronic address: charlotte.hager@umu.se.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Häger
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000502:physiology / Q000503:physiopathology; D000070598:Anterior Cruciate Ligament Injuries / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007717:Knee / Q000502:physiology* / Q000503:physiopathology; D008297:Male; D016059:Range of Motion, Articular; D016138:Walking
keywords: Anterior cruciate ligament rupture; Kinematics; Stair ambulation; Statistical parametric mapping