Highlights
- •We evaluated inter-limb asymmetry in adolescents post-ACL reconstruction.
- •Inter-limb asymmetry was present throughout the entirety of a complex jumping task.
- •More load was consistently placed on the non-surgical limb.
- •The asymmetry was significantly greater compared to healthy controls.
Abstract
Background
Limb asymmetry after ACL reconstruction is often cited as a risk factor for ACL reinjury.
We assessed ground reaction forces on each limb during a drop vertical jump, and compared
kinetic symmetry between limbs in adolescents post-ACL reconstruction versus healthy
controls.
Methods
Forty-four participants who underwent an ACL reconstruction (16 male/28 female, mean
age 16.1 ± 1.5, mean 7.3 ± 0.9 months post-ACL reconstruction) and 34 controls (20
male/14 female, mean age 14.9 ± 1.1) completed a drop vertical jump captured on a
Vicon system and Bertec force plates. Kinetic variables were calculated individually
for each limb. Inter-limb asymmetry was calculated as an index between each limb (involved
versus uninvolved for the ACL reconstruction group, and left versus right for controls),
and was compared between groups using independent t-tests.
Findings
Asymmetry was significantly more pronounced in the ACL reconstruction group versus
the controls for peak contact ground reaction force (11.6% vs 4.4%, p = 0.009), eccentric impulse (8.8% vs 3.8%, p = 0.009), eccentric mean force (8.0%
vs 3.4%, p = 0.006), concentric peak ground reaction force (4.1% vs 0.8%, p = 0.003), concentric impulse (5.1% vs 1.1%, p = 0.001), and peak landing ground reaction force (12.7% vs 1.7%, p < 0.001).
Interpretation
Limb kinetic asymmetry during a drop vertical jump was more pronounced in adolescents
post-ACL reconstruction versus controls for both eccentric- and concentric-phase variables,
which may indicate the use of compensatory strategies to offload the post-operative
limb. Targeted interventions to produce more symmetric loading and unloading during
jumping tasks should be developed, tested, and monitored to determine the impact on
rehabilitation programs, return-to-sport evaluations, and injury prevention outcomes.
Keywords
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Article info
Publication history
Published online: October 08, 2022
Accepted:
October 4,
2022
Received:
April 12,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
