Hamstring Strength Asymmetry at 3 Years after Anterior Cruciate Ligament Reconstruction Alters Knee Mechanics during Gait and Jogging

Matthew N. Abourezk, Matthew P. Ithurburn, Michael P. McNally, Louise M. Thoma, Matthew S. Briggs, Timothy Hewett, Kurt P. Spindler, Christopher C. Kaeding, Laura C. Schmitt

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Anterior cruciate ligament reconstruction (ACLR) using a hamstring tendon autograft often results in hamstring muscle strength asymmetry. However, the effect of hamstring muscle strength asymmetry on knee mechanics has not been reported. Hypothesis: Participants with hamstring strength asymmetry would demonstrate altered involved limb knee mechanics during walking and jogging compared with those with more symmetric hamstring strength at least 2 years after ACLR with a hamstring tendon autograft. Study Design: Controlled laboratory study. Methods: There were a total of 45 participants at least 2 years after ACLR (22 male, 23 female; mean time after ACLR, 34.6 months). A limb symmetry index (LSI) was calculated for isometric hamstring strength to subdivide the sample into symmetric hamstring (SH) (LSI ≥90%; n = 18) and asymmetric hamstring (AH) (LSI <85%; n = 18) groups. Involved knee kinematic and kinetic data were collected using 3-dimensional motion analysis during gait and jogging. Peak sagittal-, frontal-, and transverse-plane knee angles and sagittal-plane knee moments and knee powers were calculated. Independent-samples t tests and analyses of covariance were used to compare involved knee kinematic and kinetic variables between the groups. Results: There were no differences in sagittal- and frontal-plane knee angles between the groups (P >.05 for all). The AH group demonstrated decreased tibial internal rotation during weight acceptance during gait (P =.01) and increased tibial external rotation during jogging at initial contact (P =.03) and during weight acceptance (P =.02) compared with the SH group. In addition, the AH group demonstrated decreased peak negative knee power during midstance (P =.01) during gait compared with the SH group, after controlling for gait speed, which differed between groups. Conclusion: Participants with hamstring strength asymmetry showed altered involved knee mechanics in the sagittal plane during gait and in the transverse plane during gait and jogging compared with those with more symmetric hamstring strength. Clinical Relevance: Hamstring strength asymmetry is common at 3 years after ACLR with a hamstring tendon autograft and affects involved knee mechanics during gait and jogging. Additional research is warranted to further investigate the longitudinal effect of these alterations on knee function and joint health after ACLR.

Original languageEnglish (US)
Pages (from-to)97-105
Number of pages9
JournalAmerican Journal of Sports Medicine
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Jogging
Anterior Cruciate Ligament Reconstruction
Mechanics
Gait
Knee
Autografts
Extremities
Muscle Strength
Weights and Measures
Knee Joint
Walking
Health
Research
Hamstring Tendons

Keywords

  • ACL
  • biomechanics
  • gait analysis
  • motion analysis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Hamstring Strength Asymmetry at 3 Years after Anterior Cruciate Ligament Reconstruction Alters Knee Mechanics during Gait and Jogging. / Abourezk, Matthew N.; Ithurburn, Matthew P.; McNally, Michael P.; Thoma, Louise M.; Briggs, Matthew S.; Hewett, Timothy; Spindler, Kurt P.; Kaeding, Christopher C.; Schmitt, Laura C.

In: American Journal of Sports Medicine, Vol. 45, No. 1, 01.01.2017, p. 97-105.

Research output: Contribution to journalArticle

Abourezk, Matthew N. ; Ithurburn, Matthew P. ; McNally, Michael P. ; Thoma, Louise M. ; Briggs, Matthew S. ; Hewett, Timothy ; Spindler, Kurt P. ; Kaeding, Christopher C. ; Schmitt, Laura C. / Hamstring Strength Asymmetry at 3 Years after Anterior Cruciate Ligament Reconstruction Alters Knee Mechanics during Gait and Jogging. In: American Journal of Sports Medicine. 2017 ; Vol. 45, No. 1. pp. 97-105.
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AU - McNally, Michael P.

AU - Thoma, Louise M.

AU - Briggs, Matthew S.

AU - Hewett, Timothy

AU - Spindler, Kurt P.

AU - Kaeding, Christopher C.

AU - Schmitt, Laura C.

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N2 - Background: Anterior cruciate ligament reconstruction (ACLR) using a hamstring tendon autograft often results in hamstring muscle strength asymmetry. However, the effect of hamstring muscle strength asymmetry on knee mechanics has not been reported. Hypothesis: Participants with hamstring strength asymmetry would demonstrate altered involved limb knee mechanics during walking and jogging compared with those with more symmetric hamstring strength at least 2 years after ACLR with a hamstring tendon autograft. Study Design: Controlled laboratory study. Methods: There were a total of 45 participants at least 2 years after ACLR (22 male, 23 female; mean time after ACLR, 34.6 months). A limb symmetry index (LSI) was calculated for isometric hamstring strength to subdivide the sample into symmetric hamstring (SH) (LSI ≥90%; n = 18) and asymmetric hamstring (AH) (LSI <85%; n = 18) groups. Involved knee kinematic and kinetic data were collected using 3-dimensional motion analysis during gait and jogging. Peak sagittal-, frontal-, and transverse-plane knee angles and sagittal-plane knee moments and knee powers were calculated. Independent-samples t tests and analyses of covariance were used to compare involved knee kinematic and kinetic variables between the groups. Results: There were no differences in sagittal- and frontal-plane knee angles between the groups (P >.05 for all). The AH group demonstrated decreased tibial internal rotation during weight acceptance during gait (P =.01) and increased tibial external rotation during jogging at initial contact (P =.03) and during weight acceptance (P =.02) compared with the SH group. In addition, the AH group demonstrated decreased peak negative knee power during midstance (P =.01) during gait compared with the SH group, after controlling for gait speed, which differed between groups. Conclusion: Participants with hamstring strength asymmetry showed altered involved knee mechanics in the sagittal plane during gait and in the transverse plane during gait and jogging compared with those with more symmetric hamstring strength. Clinical Relevance: Hamstring strength asymmetry is common at 3 years after ACLR with a hamstring tendon autograft and affects involved knee mechanics during gait and jogging. Additional research is warranted to further investigate the longitudinal effect of these alterations on knee function and joint health after ACLR.

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