The purpose of this investigation was to use relative phase dynamics to evaluate gait in individuals with a reconstructed anterior cruciate ligament (ACL) during walking and running. Relative phase dynamics can describe the coordination strategies between the interacting segments at the lower extremity. Ten subjects who had undergone ACL reconstruction using the central third of their patellar tendon and ten healthy controls walked and ran on a treadmill at a self-selected pace. Relative phase dynamics were calculated for the foot-shank and shank-thigh coordinative relationships. Statistical differences between the groups were noted for the foot-shank relationship (p < 0.05) during both walking and running and for the shank-thigh relationship (p < 0.05) during walking. Our results indicate that current ACL reconstructive techniques may result in altered relative phase dynamics. These changes in relative phase dynamics could be related to a loss of sensory information about joint position and velocity that is typically provided by the intact ACL. Additionally, relative phase adaptations could be a learned response from the early stages of postsurgical rehabilitation. Relative phase dynamics provide quantitative information about the dynamic status of the ACL-reconstructed knee that cannot be gained from the conventional time-series evaluation of gait analysis data. Relative phase dynamics measures should supplement the conventional gait analysis measures that are used today for the clinical evaluation of the functional dynamic stability of the reconstructed knee. The examination of relative phase dynamics could be clinically important for the quantification of new ACL surgical interventions and of patient performance at various stages of rehabilitation. Further research should incorporate relative phase dynamics to understand the influence of ACL reconstruction on coordination and functional patient outcomes.
Early locomotor behavior has been the focus of considerable attention by developmentalists over several decades. Few studies have addressed explicitly patterns of muscle activity that underlie this coordination pattern. Our purposes were to illustrate a method to determine objectively the onset and offset of muscle firings during early walking and to investigate the emergence of patterns of activation of the core locomotor muscles. We tested eight toddlers as they walked overground at walking onset (max. of 3-6 independent steps) and after three months of walking experience. Surface electrodes monitored activity of the gastrocnemius, tibialis anterior, quadriceps, and hamstrings. We reduced EMG signals to a frame-by-frame designation of "on-off," followed by muscle state and cocontraction analyses, and probability distributions for each muscle's activity across multiple cycles. Our results clearly show that at walking onset muscle activity was highly variable with few, if any, muscles showing recurring patterns of behavior, within or among toddlers. Variability and coactivation decreased with walking experience but remained inconsistent, in contrast to the significant increase in stability shown for joint coordination and endpoint (foot placement) parameters. We propose this trend emerges because of the high number of options (muscle combinations) available. Toddlers learn first to marshal sufficient force to balance and make forward progress but slowly discover how to optimize these resources.
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