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Pairot de Fontenay B1, Willy R2, Roy J-S1
1Laval University, CIRRIS, Quebec, Canada, 2The University of Montana, School of Physical Therapy and Rehabilitation Science, Missoula, United States
Background: After anterior cruciate ligament reconstruction, the level of pain experienced by the patient is a critical parameter used by clinicians to individualize the rehabilitation progression. Running is a basic tenant of modern rehabilitation programs and field and court sports require running. For the patient, return to running is an important milestone of the recovery after ACL-R. However, the pain experienced by the patients and the association between pain level and biomechanical parameters linked to load absorption at return to running are unknown.
Purpose: The aim of this study is to report both pain level and pain location during the first session of running after ACL-R and to determine the biomechanical parameters associated with the presence of pain.
Methods: 14 participants (8 males and 6 females; age: 26±5; height: 169±8 cm; weight: 69±10 kg) were recruited between 3 and 5 months (3.5±0.5 months) after ACL-R by a hamstring autograft. The first session of running consisted in 3*1 minute of running at 9km/h. Pain intensity (on a 0-10 scale) experienced during running and pain location were reported. Kinematics (peak knee flexion) and kinetics (vertical average loading rate [VALR]), peak internal knee extension moment (iKEM), peak internal abduction moment and knee support moment (relatively to the total support moment) were calculated from 3D motion capture system (Bertec instrumented treadmill and Vicon cameras). Pearson correlation coefficients were calculated to determine the association between pain level and biomechanical parameters.
Results: Eleven of the 14 participants reported pain during running (mean: 1.4, range: 0.3 to 4/10), and pain was located inside the knee joint during the stance phase of running for eight of these participants. The pain level experienced during running was negatively correlated to both peak iKEM and knee support moment (p=0.05, r= -0.46; p=0.03, r= -0.51, respectively). However, pain level was not correlated to peak knee flexion, VALR, and peak internal knee abduction moment (all p>0.05).
Conclusion(s): In our study, 79% of the patients experienced pain during the first session of running after ACL-R, with 73% of these patients reporting pain inside their knee joint. The level of pain experienced during the first running session after ACL-R was negatively associated to iKEM (peak and knee support moment).
Implications: Running gait modifications that decrease the demand on the knee joint (such as increased step-rate or forefoot strike) should be investigated to determine their immediate effects in patients who experienced pain during running after ACL-R.
Keywords: Biomechanic, gait analysis, ACL
Funding acknowledgements: This work was funding by a grant of the ordre professionel de la physiothérapie du Québec (OPPQ).
Purpose: The aim of this study is to report both pain level and pain location during the first session of running after ACL-R and to determine the biomechanical parameters associated with the presence of pain.
Methods: 14 participants (8 males and 6 females; age: 26±5; height: 169±8 cm; weight: 69±10 kg) were recruited between 3 and 5 months (3.5±0.5 months) after ACL-R by a hamstring autograft. The first session of running consisted in 3*1 minute of running at 9km/h. Pain intensity (on a 0-10 scale) experienced during running and pain location were reported. Kinematics (peak knee flexion) and kinetics (vertical average loading rate [VALR]), peak internal knee extension moment (iKEM), peak internal abduction moment and knee support moment (relatively to the total support moment) were calculated from 3D motion capture system (Bertec instrumented treadmill and Vicon cameras). Pearson correlation coefficients were calculated to determine the association between pain level and biomechanical parameters.
Results: Eleven of the 14 participants reported pain during running (mean: 1.4, range: 0.3 to 4/10), and pain was located inside the knee joint during the stance phase of running for eight of these participants. The pain level experienced during running was negatively correlated to both peak iKEM and knee support moment (p=0.05, r= -0.46; p=0.03, r= -0.51, respectively). However, pain level was not correlated to peak knee flexion, VALR, and peak internal knee abduction moment (all p>0.05).
Conclusion(s): In our study, 79% of the patients experienced pain during the first session of running after ACL-R, with 73% of these patients reporting pain inside their knee joint. The level of pain experienced during the first running session after ACL-R was negatively associated to iKEM (peak and knee support moment).
Implications: Running gait modifications that decrease the demand on the knee joint (such as increased step-rate or forefoot strike) should be investigated to determine their immediate effects in patients who experienced pain during running after ACL-R.
Keywords: Biomechanic, gait analysis, ACL
Funding acknowledgements: This work was funding by a grant of the ordre professionel de la physiothérapie du Québec (OPPQ).
Topic: Musculoskeletal: lower limb; Sport & sports injuries
Ethics approval required: Yes
Institution: CIUSS de la Capitale- Nationale
Ethics committee: de la recherche sectoriel en réadaptation et intégration sociale
Ethics number: 2017 - 564
All authors, affiliations and abstracts have been published as submitted.
