Development of Visual Biofeedback Strategies to Reduce Joint Loading Asymmetry in Individuals Post ACL Reconstruction

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Abstract

Abnormal movement patterns that offload the surgical knee persist over time in individuals post anterior cruciate ligament reconstruction (ACLR). Individuals post ACLR exhibit asymmetries in vertical ground reaction force (vGRF) and center of pressure (COP) location.

To address these asymmetrical loading patterns during bilateral tasks, we used visual biofeedback strategies incorporating vGRF and COP information to investigate if visual biofeedback strategies can improve weight bearing asymmetry and joint loading asymmetry in individuals post ACLR and recreational athletes. The visual biofeedback strategies for this current study include three different feedbacks: 1) vGRF, 2) COP, and 3) a combination of vGRF and COP (vGRFCOP).

The first goal, Chapter 3, is to assess the effect of the visual biofeedback strategies on reducing weight bearing asymmetry in individuals post ACLR and recreational athletes during bilateral squats. Weight bearing asymmetry improved in the individuals post ACLR and recreational athletes when provided visual biofeedback. These results suggest that incorporating vGRF and COP information is essential to reduce weight bearing asymmetry in individuals postACLR to avoid COP asymmetry when provided vGRF only. In Chapter 4, we explored the immediate effect of the three different visual biofeedback strategies on reducing joint loading asymmetry and lower extremity biomechanics in individuals post ACLR and recreational athletes during bilateral squats. Joint loading asymmetry improved in both the individuals post ACLR and recreational athletes when provided vGRF and vGRFCOP feedback. Lastly, in Chapter 5, we identified muscle coordination in individuals post ACLR and recreational athletes with and without visual biofeedback during bilateral squats. The third study found that individuals post ACLR may adapt different movement strategies when performing bilateral tasks with and without visual biofeedback.

Collectively, visual biofeedback incorporating COP information improved weight bearing asymmetry and joint loading asymmetry in individuals post ACLR during bilateral squats. Understanding movement strategies in individuals post ACLR and recreational athletes during bilateral tasks when providing visual biofeedback can assist in developing rehabilitation strategies and exercise programs.

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