Evaluation of static and dynamic balance in athletes with anterior cruciate ligament injury – A controlled study

Abstract

OBJECTIVES:Anterior cruciate ligament injury leads to adaptive responses to maintain postural control. However, there is no consensus regarding whether leg dominance also affects postural control in athletes with anterior cruciate ligament injury. The purpose of this study was to evaluate dynamic and static postural control among athletes with and without anterior cruciate ligament injury to the dominant leg.METHODS:Twenty-eight athletes, twenty-one males and seven females aged 15-45 years, were allocated to one of two groups: the anterior cruciate ligament injury group (26±3 years) or the control group without anterior cruciate ligament injury (25±6.5 years). All subjects performed one legged stance tests under eyes open and eyes closed conditions and squat and kick movement tests using a postural control protocol (AccuSwayPlus force platform, Massachusetts). The center of pressure displacement and speed were measured by the force platform. In addition, the distance traveled on the single-leg hop test was assessed as an objective measure of function.RESULTS:Significantly greater mediolateral sway was found under the eyes closed condition (p=0.04) and during squat movement (p=0.01) in the anterior cruciate ligament injury group than in the control group. Analysis of the single-leg hop test results showed no difference between the groups (p=0.73).CONCLUSION:Athletes with anterior cruciate ligament injury had greater mediolateral displacement of the center of pressure toward the dominant leg under the eyes closed condition and during squat movement compared to control athletes.

Single-Leg Assessment of Postural Stability After Anterior Cruciate Ligament Injury: a Systematic Review and Meta-Analysis

“…Eight investigations in ACL patients [ 13 , 16 , 18 , 27 , 33 , 52 , 53 , 57 ] compared sway magnitude of the injured leg to the matched leg of healthy controls, indicating a significantly increased total sway magnitude in the ACL group (Fig. 2 , SMD wm = 0.94, p = 0.003, CI = 0.32, 1.56, I 2 = 88%).…”

“…3 , SMD wm = 0.58, p = 0.02, CI = 0.10, 1.06, I 2 = 62%) as well as the mediolateral direction (Fig. 4 , SMD wm = 1.15, p = 0.02, CI = 0.18, 2.12, I 2 = 89%) for the injured knee [ 16 , 18 , 38 , 52 ]. Comparisons of sway velocity in the injured and matched limb were conducted in seven studies [ 13 , 18 , 38 , 40 , 52 , 57 , 62 ].…”

“…4 , SMD wm = 1.15, p = 0.02, CI = 0.18, 2.12, I 2 = 89%) for the injured knee [ 16 , 18 , 38 , 52 ]. Comparisons of sway velocity in the injured and matched limb were conducted in seven studies [ 13 , 18 , 38 , 40 , 52 , 57 , 62 ]. Collectively, the meta-analysis yielded a medium effect for sway velocity (SMD wm = 0.66, p = 0.0002, CI = 0.31, 1.00, I 2 = 56%), indicating a significant increase in the ACL-injured leg compared to the control group (Fig.…”

“…In line with Howells et al [ 28 ] and Negahban et al [ 41 ], the present findings support that postural sway is altered in patients after ACL injury. Medium to large effects were found for increased total sway magnitudes [ 13 , 16 , 18 , 52 , 53 , 57 ], as well as increased anteroposterior and mediolateral sway in the injured leg [ 16 , 18 , 38 , 52 ]. On the other hand, two studies [ 27 , 33 ] found decreased postural sway in ACL patients compared to healthy controls.…”

“…If the included studies did not report means, standard deviations, or F values, the corresponding authors were contacted. In two of three cases, the authors responded [ 18 , 57 ] and the respective study was included, while the remainder [ 21 ] was excluded from this meta-analysis.…”