Spatiotemporal lower-limb asymmetries during stair descent in athletes following anterior cruciate ligament reconstruction

• DOI: 10.1016/j.jelekin.2024.102868
• Publication Date: 2024-02-11T00:15:31Z
• Authors: Dario G. Liebermann; Jonas L. Markström; Jonas Selling; Charlotte K. Häger
• Keywords: Spatiotemporal features; Stair descent; ACL injury; 03 medical and health sciences; 0302 clinical medicine; Procrustes analysis; Return-to-sport; Physiotherapy; Fysioterapi

This study evaluated motor control recovery at different times following anterior cruciate ligament reconstruction (ACLR) by investigating lower-limb spatiotemporal symmetry during stair descent performances.We used a cross-sectional design to compare asymptomatic athletes (Controls, n = 18) with a group of people with ACLR (n = 49) divided into three time-from-ACLR subgroups (Early: <6 months, n = 17; Mid: 6-18 months, n = 16; Late: ≥18 months, n = 16). We evaluated: "temporal symmetry" during the stance subphases (single-support, first and second double-support) and "spatial symmetry" for hip-knee-ankle intra-joint angular displacements during the stance phase using a dissimilarity index applied on superimposed 3D phase plots.We found significant between-group differences in temporal variables (p ≤ 0.001). Compared to Controls, both Early and Mid (p ≤ 0.05) showed asymmetry in the first double-support time (longer for their injured vs. non-injured leg), while Early generally also showed longer durations in all other phases, regardless of stepping leg. No statistically significant differences were found for spatial intra-joint symmetry between groups.Temporal but not spatial asymmetry in stair descent is often present early after ACLR; it may remain for up to 18 months and may underlie subtle intra- and inter-joint compensations. Spatial asymmetry may need further exploration.