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.

Cited Works (9)

Year	Entry
2007	Delp SL, Anderson FC, Arnold AS, Loan P, Habib A, John CT, Guendelman E, Thelen DG. OpenSim: open-source software to create and analyze dynamic simulations of movement. IEEE Trans Biomed Eng. November 2007;54(11):1940-1950.
2001	Neptune RR, Kautz SA, Zajac FE. Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking. J Biomech. November 2001;34(11):1387-1398.
2006	Liu MQ, Anderson FC, Pandy MG, Delp SL. Muscles that support the body also modulate forward progression during walking. J Biomech. 2006;39(14):2623-2630.
2007	Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. October 2007;35(10):1756-1769.
1997	Kepple TM, Siegel KL, Stanhope SJ. Relative contributions of the lower extremity joint moments to forward progression and support during gait. Gait Post. August 1997;6(1):1-8.
2009	Boden BP, Torg JS, Knowles SB, Hewett TE. Video analysis of anterior cruciate ligament injury: abnormalities in hip and ankle kinematics. Am J Sports Med. February 2009;37(2):252-259.
2008	Liu MQ, Anderson FC, Schwartz MH, Delp SL. Muscle contributions to support and progression over a range of walking speeds. J Biomech. November 14, 2008;41(15):3243-3252.
2000	von Tscharner V. Intensity analysis in time-frequency space of surface myoelectric signals by wavelets of specified resolution. J Electromyogr Kinesiol. December 2000;10(6):433-445.
2000	Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. October 2000;10(5):361-374.