Effects of Anterior Cruciate Ligament (ACL) Injury on Muscle Activity of Head, Neck and Trunk Muscles: A Cross-Sectional Evaluation

CRANIO® ◽  
2007 ◽  
Vol 25 (3) ◽  
pp. 177-185 ◽  
Author(s):  
Simona Tecco ◽  
Vincenzo Salini ◽  
Stefano Teté ◽  
Felice Festa ◽  
Christian Colucci
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Activity ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Trunk Muscles ◽  
Cross Sectional ◽  
Anterior Cruciate ◽  
Head Neck

scholarly journals Protracted Cardiovascular Impairments After Anterior Cruciate Ligament Injury: A Critically Appraised Topic

2020 ◽  
Vol 29 (5) ◽  
pp. 680-683
Author(s):  
Cody R. Butler ◽  
Kirsten Allen ◽  
Lindsay J. DiStefano ◽  
Lindsey K. Lepley
Keyword(s):  
Physical Activity ◽  
Anterior Cruciate Ligament ◽  
National Football League ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Cross Sectional ◽  
History Of ◽  
Cross Sectional Studies ◽  
Anterior Cruciate ◽  
Cv Disease

Clinical Scenario: Anterior cruciate ligament (ACL) tear is a devastating knee injury with negative long-term consequences, such as early-onset knee osteoarthritis, biomechanical compensations, and reduced physical activity. Significant reduction in physical activity is a powerful indicator of cardiovascular (CV) disease; therefore, those with a history of ACL injury may be at increased risk for CV disease compared with noninjured individuals. Focused Clinical Question: Do individuals with a history of ACL injury demonstrate negative CV changes compared with those without a history of ACL injury? Summary of Key Findings: Three articles met the inclusion criteria and investigated CV changes after ACL injury. Both cross-sectional studies compared participants with ACL injury with matched controls. Bell et al compared time spent in moderate to vigorous physical activity and step count, whereas Almeida et al compared maximum rate of oxygen consumption, ventilatory thresholds, isokinetic quadriceps strength, and body composition. Collectively, both quantitative studies found that individuals with a history of ACL injury had less efficient CV systems compared with matched controls and/or preoperative data. Finally, a qualitative study of 3506 retired National Football League athletes showed an increased rate of arthritis and knee replacement surgery after an ACL injury when compared with other retired National Football League members, in addition to a >50% increased rate of myocardial infarction. Clinical Bottom Line: A history of ACL injury is a source of impaired physical activity. Preliminary data indicate that these physical activity limitations negatively impair the CV system, and individuals with a history of ACL injury demonstrate lower maximum oxygen consumption, self-reported disability, and daily step count compared with noninjured peers. These complications support the need for greater emphasis on CV wellness. Strength of Recommendation: Consistent findings from 2 cross-sectional studies and 1 survey study suggest level IIB evidence to support that ACL injury is associated with negative CV health.

scholarly journals Posttraumatic Bone Marrow Lesion Volume and Knee Pain Within 4 Weeks After Anterior Cruciate Ligament Injury

2017 ◽  
Vol 52 (6) ◽  
pp. 575-580 ◽  
Author(s):  
Jeffrey B. Driban ◽  
Stefan Lohmander ◽  
Richard B. Frobell
Keyword(s):  
Bone Marrow ◽  
Anterior Cruciate Ligament ◽  
Knee Pain ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Bone Marrow Lesion ◽  
Bone Bruise ◽  
Cross Sectional ◽  
Anterior Cruciate

Context:  After an anterior cruciate ligament (ACL) injury, a majority of patients have a traumatic bone marrow lesion (BML, or bone bruise). The clinical relevance of posttraumatic lesions remains unclear. Objective:  To explore the cross-sectional associations between traumatic BML volume and self-reported knee pain and symptoms among individuals within 4 weeks of ACL injury. Design:  Cross-sectional exploratory analysis of a randomized clinical trial. Setting:  Orthopaedic departments at 2 hospitals in Sweden. Patients or Other Participants:  As part of a randomized trial (knee anterior cruciate ligament nonoperative versus operative treatment [KANON] study), 121 young active adults (74% men, age = 26 ± 5 years, height = 1.8 ± 0.1 m, weight = 76 ± 13 kg) with an ACL tear were studied. Main Outcome Measure(s):  The BML volume in the proximal tibia and distal femur was segmented using magnetic resonance images obtained within 4 weeks of injury. A radiologist evaluated the presence of depression fractures on the images. Pain and symptoms of the injured knee (Knee Injury and Osteoarthritis Outcome Score [KOOS] pain and symptoms subscales) were obtained the same day as imaging. We used linear regression models to assess the associations. Results:  Most knees had at least 1 BML (96%), and the majority (57%) had a depression fracture. Whole-knee BML volume was not related to knee pain for the entire cohort (β = −0.09, P = .25). Among those without a depression fracture, larger whole-knee BML volume was associated with increased knee pain (β = –0.46, P = .02), whereas no association was found for those with a depression fracture (β = 0.0, P = .96). Larger medial (β = –0.48, P = .02) but not lateral (β = –0.03, P = .77) tibiofemoral BML volume was associated with greater pain. We found no association between BML volume and knee symptoms. Conclusions:  We confirmed the absence of relationships between whole-knee BML volume and pain and symptoms within 4 weeks of ACL injury. Our findings extend previous reports in identifying weak associations between larger BML volume in the medial compartment and greater pain and between BML volume and greater pain among those without a depression fracture.

scholarly journals Sex Comparisons of In Vivo Anterior Cruciate Ligament Morphometry

2019 ◽  
Vol 54 (5) ◽  
pp. 513-518 ◽  
Author(s):  
Hsin-Min Wang ◽  
Sandra J. Shultz ◽  
Scott E. Ross ◽  
Robert A. Henson ◽  
David H. Perrin ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sex Differences ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Cross Sectional ◽  
Notch Width ◽  
Anterior Cruciate ◽  
Femoral Notch

Context Females have consistently higher anterior cruciate ligament (ACL) injury rates than males. The reasons for this disparity are not fully understood. Whereas ACL morphometric characteristics are associated with injury risk and females have a smaller absolute ACL size, comprehensive sex comparisons that adequately account for sex differences in body mass index (BMI) have been limited. Objective To investigate sex differences among in vivo ACL morphometric measures before and after controlling for femoral notch width and BMI. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants Twenty recreationally active men (age = 23.2 ± 2.9 years, height = 180.4 ± 6.7 cm, mass = 84.0 ± 10.9 kg) and 20 recreationally active women (age = 21.3 ± 2.3 years, height = 166.9 ± 7.7 cm, mass = 61.9 ± 7.2 kg) participated. Main Outcome Measure(s) Structural magnetic resonance imaging sequences were performed on the left knee. Anterior cruciate ligament volume, width, and cross-sectional area measures were obtained from T2-weighted images and normalized to femoral notch width and BMI. Femoral notch width was measured from T1-weighted images. We used independent-samples t tests to examine sex differences in absolute and normalized measures. Results Men had greater absolute ACL volume (1712.2 ± 356.3 versus 1200.1 ± 337.8 mm3; t38 = −4.67, P < .001) and ACL width (8.5 ± 2.3 versus 7.0 ± 1.2 mm; t38 = −2.53, P = .02) than women. The ACL volume remained greater in men than in women after controlling for femoral notch width (89.31 ± 15.63 versus 72.42 ± 16.82 mm3/mm; t38 = −3.29, P = .002) and BMI (67.13 ± 15.40 versus 54.69 ± 16.39 mm3/kg/m2; t38 = −2.47, P = .02). Conclusions Whereas men had greater ACL volume and width than women, only ACL volume remained different when we accounted for femoral notch width and BMI. This suggests that ACL volume may be an appropriate measure of ACL anatomy in investigations of ACL morphometry and ACL injury risk that include sex comparisons.

Hip Abductor and Adductor Muscles Activity Patterns During Landing After Anterior Cruciate Ligament Injury

2019 ◽  
Vol 28 (8) ◽  
pp. 871-876 ◽  
Author(s):  
Komeil Dashti Rostami ◽  
Aynollah Naderi ◽  
Abbey Thomas
Keyword(s):  
Anterior Cruciate Ligament ◽  
Athletic Training ◽  
Muscle Activity ◽  
Cruciate Ligament ◽  
Activity Patterns ◽  
Acl Injury ◽  
Initial Contact ◽  
Adductor Muscles ◽  
Anterior Cruciate ◽  
Adductor Longus

Context: Hamstring and quadriceps activity adaptations are well known in individuals with anterior cruciate ligament deficiency (ACLD) and reconstructed (ACLR) to potentially compensate for knee joint instability. However, few studies have explored hip muscles activity patterns after ACL injury. Objective: To examine the activation characteristics of gluteus medius (GMED) and adductor longus in ACLR and ACLD subjects compared with controls. Design: Case–control study. Setting: Athletic training room and university lab. Participants: Twelve healthy and 24 ACL-injured (12 ACLR and 12 ACLD) recreationally active male volunteers. Interventions: Surface electromyography of the GMED and adductor longus were recorded during a single-leg vertical drop landing and normalized to maximum voluntary isometric contractions. Main Outcome Measures: Preparatory and reactive muscle activity and coactivation were analyzed from 100 milliseconds prior to initial contact to 250 milliseconds postcontact. Results: During reactive activity, ACL-injured (ACLR and ACLD) participants demonstrated significantly lower peak GMED activity compared with controls (F = 4.33, P = .02). In addition, ACLR participants exhibited significantly lower reactive GMED:adductor longus coactivation muscle activity compared with controls (F = 4.09, P = .03). Conclusion: Our findings suggest neuromuscular adaptations of the hip musculature are present in people at least 2 years from ACL injury. GMED activation exercises should be considered in designing rehabilitation programs for ACL-injured individuals.

scholarly journals Hamstring Muscle Activity After Primary Anterior Cruciate Ligament Reconstruction—A Protective Mechanism in Those Who Do Not Sustain a Secondary Injury? A Preliminary Study

2019 ◽  
Vol 11 (4) ◽  
pp. 316-323 ◽  
Author(s):  
Riann M. Palmieri-Smith ◽  
Meagan Strickland ◽  
Lindsey K. Lepley
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Activity ◽  
Muscle Activation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Quadriceps Muscle ◽  
Protective Mechanism ◽  
Secondary Injury ◽  
Ground Contact ◽  
Anterior Cruciate

Background:Individuals who experience a subsequent ipsilateral anterior cruciate ligament (ACL) reinjury may use hazardous muscle activation strategies after primary ACL reconstruction (ACLR). The purpose of this study was to compare electromyograms (EMGs) of the quadriceps, hamstrings, and gastrocnemius muscles during a dynamic hopping task among individuals with a single ACL injury (ACLx1), individuals who went on to have secondary ipsilateral ACL injury (ACLx2), and individuals who have never sustained an ACL injury (ACLx0).Hypothesis:We expected that individuals who went on to experience a secondary ACL injury would use less quadriceps muscle activity as compared with individuals who experienced a single ACL injury.Study Design:Cross-sectional study.Level of Evidence:Level 3.Methods:Fourteen individuals that were returned to play post-ACLR and 7 non-ACL-injured individuals participated. Individuals who had undergone an ACLR were placed into groups depending on whether they had experienced a secondary ipsilateral ACL reinjury postprimary ACLR. EMG data of the vastus lateralis, biceps femoris, and lateral gastrocnemius were measured during 2 phases of a single-leg dynamic hopping task: preactivity (100 ms prior to ground contact) and reactivity (250 ms post–ground contact). Processed EMG data were compared across groups using 1-way analyses of variance, with post hoc independent t tests where appropriate ( P ≤ 0.05).Results:At preactivity, ACLx1 (0.48% ± 0.2%max) was found to use significantly more hamstring activity than ACLx2 (0.20% ± 0.1%max, P = 0.018), but not than ACLx0 (0.38% ± 0.1%max, P > 0.05). At reactivity, both ACL groups were found to use less quadriceps activity than ACLx0 (ACLx1: 0.38% ± 0.1%max, P = 0.016; ACLx2: 0.40% ± 0.1%max, P = 0.033; ACLx0: 0.58% ± 0.1%max), but not than each other ( P > 0.05).Conclusion:Quadriceps muscle activity during landing was diminished in all ACL participants as compared with participants who had never sustained an ACL injury. Individuals who did not experience a secondary ipsilateral ACL reinjury (ACLx1) used greater levels of hamstring activity prior to landing.Clinical Relevance:The higher hamstring activity in patients who did not experience a secondary injury may be interpreted as a protective mechanism that is used to dynamically stabilize the reconstructed limb.

scholarly journals Electromyographic Assessment of Anterior Cruciate Ligament Injury Risk in Male Tennis Players: Which Role for Visual Input? A Proof-of-Concept Study

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 997
Author(s):  
Alessandro de Sire ◽  
Nicola Marotta ◽  
Andrea Demeco ◽  
Lucrezia Moggio ◽  
Pasquale Paola ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Visual Input ◽  
Proof Of Concept ◽  
Tennis Players ◽  
Concept Study ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury incidence is often underestimated in tennis players, who are considered as subjects conventionally less prone to knee injuries. However, evaluation of the preactivation of knee stabilizer muscles by surface electromyography (sEMG) showed to be a predictive value in the assessment of the risk of ACL injury. Therefore, this proof-of-concept study aimed at evaluating the role of visual input on the thigh muscle preactivation through sEMG to reduce ACL injury risk in tennis players. We recruited male, adult, semiprofessional tennis players from July to August 2020. They were asked to drop with the dominant lower limb from a step, to evaluate—based on dynamic valgus stress—the preactivation time of the rectus femoris (RF), vastus medialis, biceps femoris, and medial hamstrings (MH), through sEMG. To highlight the influence of visual inputs, the athletes performed the test blindfolded and not blindfolded on both clay and grass surfaces. We included 20 semiprofessional male players, with a mean age 20.3 ± 4.8 years; results showed significant early muscle activation when the subject lacked visual input, but also when faced with a less-safe surface such as clay over grass. Considering the posteromedial–anterolateral relationship (MH/RF ratio), tennis players showed a significant higher MH/RF ratio if blindfolded (22.0 vs. 17.0% not blindfolded; p < 0.01) and percentage of falling on clay (17.0% vs. 14.0% in grass; p < 0.01). This proof-of-principle study suggests that in case of absence of visual input or falling on a surface considered unsafe (clay), neuro-activation would tend to protect the anterior stress of the knee. Thus, the sEMG might play a crucial role in planning adequate athletic preparation for semiprofessional male athletes in terms of reduction of ACL injury risk.

scholarly journals Anterior Cruciate Ligament Injury Prevention Exercises: Could a Neuromuscular Warm-Up Improve Muscle Pre-Activation before a Soccer Game? A Proof-of-Principle Study on Professional Football Players

2021 ◽  
Vol 11 (11) ◽  
pp. 4958
Author(s):  
Alessandro de Sire ◽  
Andrea Demeco ◽  
Nicola Marotta ◽  
Lucrezia Moggio ◽  
Arrigo Palumbo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Football Players ◽  
Professional Football ◽  
Activation Time ◽  
Exercise Protocol ◽  
Warm Up ◽  
Anterior Cruciate ◽  
Proof Of Principle

Neuromuscular warm-up has been shown to decrease the risk of anterior cruciate ligament (ACL) injury improving muscular firing patterns. All preventive training programs described in the literature have a duration of several weeks. To date, no studies have explored the immediate effect of a neuromuscular warm-up exercise on pre-activation time of the knee stabilizer muscles. Thus, this proof-of-principle study aimed at evaluating the acute effects of a neuromuscular warm-up exercises on the electromyographic activation of knee stabilizer muscles’ activation pattern. We included 11 professional football players, mean aged 23.2 ± 4.5 years, from a Southern Italy football team. All of them underwent a standard warm-up exercise protocol at the first day of the evaluation. At 1 week, they underwent a structured neuromuscular warm-up exercise protocol. We assessed as outcome measure the pre-activation time (ms) of rectus femoris (RF), vastus medialis (VM), biceps femoris (BF), and medial hamstrings (MH) upon landing. Outcomes were assessed before and after the standard warm-up and neuromuscular warm-up. Pre-activation time of RF, VM, BF and MH significantly improved only after neuromuscular warm-up (p < 0.05); moreover, there was a significant (p < 0.05) between-group difference in pre-activation time of all muscles after the neuromuscular warm-up compared with the standard warm-up. These findings suggested that physical exercise consisting of a structured injury prevention neuromuscular warm-up might have an immediate effect in improving the activation time of the knee stabilizer muscles, thus potentially reducing the risk of ACL injury.

Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears

2021 ◽  
pp. 194173812110295
Author(s):  
Patrick Ward ◽  
Peter Chang ◽  
Logan Radtke ◽  
Robert H. Brophy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Bone Bruises ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are common injuries; they are often associated with concomitant injuries to other structures in the knee, including bone bruises. While there is limited evidence that bone bruises are associated with slightly worse clinical outcomes, the implications of bone bruises for the articular cartilage and the risk of developing osteoarthritis (OA) in the knee are less clear. Recent studies suggest that the bone bruise pattern may be helpful in predicting the presence of meniscal ramp lesions. Evidence Acquisition: A literature review was performed in EMBASE using the keyword search phrase (acl OR (anterior AND cruciate AND ligament)) AND ((bone AND bruise) OR (bone AND contusion) OR (bone AND marrow AND edema) OR (bone AND marrow AND lesion) OR (subchondral AND edema)). Study Design: Clinical review. Level of Evidence: Level 4. Results: The literature search returned 93 articles of which 25 were ultimately included in this review. Most studies identified a high prevalence of bone bruises in the setting of acute ACL injury. Individual studies have found relationships between bone bruise volume and functional outcomes; however, these results were not supported by systematic review. Similarly, the literature has contradictory findings on the relationship between bone bruises and the progression of OA after ACL reconstruction. Investigations into concomitant injury found anterolateral ligament and meniscal ramp lesions to be associated with bone bruise presence on magnetic resonance imaging. Conclusion: Despite the ample literature identifying the prevalence of bone bruises in association with ACL injury, there is little evidence to correlate bone bruises to functional outcomes or progression of OA. Bone bruises may best be used as a marker for concomitant injury such as medial meniscal ramp lesions that are not always well visualized on magnetic resonance imaging. Further research is required to establish the longitudinal effects of bone bruises on ACL tear recovery. Strength of Recommendation Taxonomy: 2.

scholarly journals Rehabilitation and Return to Sport Assessment after Anterior Cruciate Ligament Injury: Quantifying Joint Kinematics during Complex High-Speed Tasks through Wearable Sensors

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2331
Author(s):  
Stefano Di Paolo ◽  
Nicola Francesco Lopomo ◽  
Francesco Della Villa ◽  
Gabriele Paolini ◽  
Giulio Figari ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Excellent Agreement ◽  
High Speed ◽  
Cruciate Ligament ◽  
Wearable Sensors ◽  
Return To Sport ◽  
Acl Injury ◽  
Wearable Sensor ◽  
Anterior Cruciate ◽  
Full Body

The aim of the present study was to quantify joint kinematics through a wearable sensor system in multidirectional high-speed complex movements used in a protocol for rehabilitation and return to sport assessment after Anterior Cruciate Ligament (ACL) injury, and to validate it against a gold standard optoelectronic marker-based system. Thirty-four healthy athletes were evaluated through a full-body wearable sensor (MTw Awinda, Xsens) and a marker-based optoelectronic (Vicon Nexus, Vicon) system during the execution of three tasks: drop jump, forward sprint, and 90° change of direction. Clinically relevant joint angles of lower limbs and trunk were compared through Pearson’s correlation coefficient (r), and the Coefficient of Multiple Correlation (CMC). An excellent agreement (r > 0.94, CMC > 0.96) was found for knee and hip sagittal plane kinematics in all the movements. A fair-to-excellent agreement was found for frontal (r 0.55–0.96, CMC 0.63–0.96) and transverse (r 0.45–0.84, CMC 0.59–0.90) plane kinematics. Movement complexity slightly affected the agreement between the systems. The system based on wearable sensors showed fair-to-excellent concurrent validity in the evaluation of the specific joint parameters commonly used in rehabilitation and return to sport assessment after ACL injury for complex movements. The ACL professionals could benefit from full-body wearable technology in the on-field rehabilitation of athletes.

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