Quadriceps Torque, Peak Variability and Strength Endurance in Patients after Anterior Cruciate Ligament Reconstruction: Impact of Local Muscle Fatigue

Niederer, Daniel; Kalo, Kristin; Vogel, J.; Wilke, Jan; Giesche, Florian; Vogt, Lutz; Banzer, Winfried

doi:10.1080/00222895.2019.1570909

Cited by 6 publications

(11 citation statements)

References 38 publications

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“…Previous studies using fatiguing exercise to disrupt muscle spindle function have provided conflicting evidence on the impact on force steadiness. Goetschius et al [14] found that fatiguing exercise increased torque variability in those with ACLR but had no impact in a control group, whereas Niederer et al [22] found that torque variability was impaired in control participants following fatigue but there was no change in those with ACLR. We used a far more specific disruption to muscle spindle function in the form of prolonged vibration.…”

Section: Discussionmentioning

confidence: 99%

“…However, in people with ACL deficiency and after ACLR, prolonged vibration has no effect on quadriceps force output or muscle activity [33,35,37,38], suggesting a pre-existing deficit in the transmission of muscle spindle input to the spinal cord, termed gamma-loop dysfunction. To examine the role of muscle spindles and the gamma loop in submaximal force regulation in people with ACLR, two studies [14,22] have used fatiguing exercise to disrupt muscle spindle output and observed the impact on force steadiness, or the ability to maintain a consistent level of force. The results of these studies were conflicting, potentially due to the differing fatigue protocols employed.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have provided evidence of greater torque variability during maximal [14][15][16][17][18] and submaximal [10,19] quadriceps contractions in people with ACL deficiency and after ACLR. The significance of this variability is evident with several of these studies showing a relationship between force variability and lower limb function [15,16,20], although this is not always consistent [21,22].…”

Section: Introductionmentioning

confidence: 99%

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Impaired Regulation of Submaximal Force after ACL Reconstruction: Role of Muscle Spindles

2020

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Ongoing motor deficits are routinely present following anterior cruciate ligament (ACL) reconstruction, including the ability to regulate muscle force. While such deficits are known, it is unclear why this occurs. The goal of the current study was to investigate the potential influence of muscle spindle input on submaximal force regulation and muscle activity at the knee in people following ACL reconstruction. Fourteen participants (8 female) who were 6−24 months post-ACL reconstruction and 15 control participants (8 female) undertook submaximal force matching and force modulation tasks before and after 20 min of vibration applied to the patella tendon. Across all tasks, the ACL reconstruction participants were poorer at force matching (P=0.007). The effect of vibration was not significant in either group for the force matching tasks (P=0.06), although there was a reduction in maximum voluntary contraction post-vibration in the control group (P<0.001). The ACL reconstruction group also showed evidence of greater activation of the medial hamstring muscles in comparison to controls (P=0.04). Individuals who have undergone ACL reconstruction have a diminished ability to accurately match and regulate submaximal muscle force, but this does not appear to be related to impaired muscle spindle input. Neuromuscular retraining programs that involve force regulation tasks may be necessary to optimize rehabilitation after ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impaired Regulation of Submaximal Force after ACL Reconstruction: Role of Muscle Spindles

2020

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“…75 Specific to our focus on asymmetry however, we found that increased RPE was associated with reduced musculoskeletal strength of the nondominant limb compared to the dominant limb (i.e., increased between-limb differences) (r = 0.70, and r = 0.63-0.70, p < 0.05; and Cohen's d = 0.27-0.51, p < 0.05, respectively), 40,42 and greater kinetic or kinematic between-limb differences during vertical jump tasks (η p 2 = 0.24-0.53, p < 0.05; no effect size reported in Webster et al, 2012). 52,78 However, contradicting findings remain, 64 and the heterogeneous findings related to fatigue and lower limb asymmetry are often reported [91][92][93][94] due to the many nuances that exist in study designs, protocols, metrics assessed, and the calculation of asymmetries. Nevertheless, the majority of findings presented on the relationship between RPE and biomechanics and/ or asymmetry, here and previously, [90][91][92][93][94] pertain to either vertical jumping or gait asymmetries, and did not directly highlight the association between RPE and asymmetry in a more prospective, longitudinal context that considers data points across multiple sessions or a complete competitive season.…”

Section: Rate Of Perceived Exertion and Biomechanical Asymmetriesmentioning

confidence: 99%

“…Surprisingly, many introspective metrics known to impact athletic performance, such as sleep and general mental health [101][102][103][104] were not identified in this scoping review. While hope, anxiety, and fear were identified in some articles, 39,64,65,68,73 these were often more associated with athletics or reinjury, rather than aspects of general mental health and well-being, which is especially concerning following the COVID-19 pandemic whereby nationwide surveys have indicated up to a two times increase in mental health disorders. 105 In addition to the lack of incorporation of relevant introspective factors such as sleep and general mental health in sports medicine research that concurrently assesses biomechanical asymmetry, the sporadic and single-domain monitoring of competitive athletes' psychological state was further demonstrated in recent work by Neupert and colleagues.…”

Section: Practical Applications and Future Directionsmentioning

confidence: 99%

Monitoring lower limb biomechanical asymmetry and psychological measures in athletic populations—A scoping review

Keogh

Waddington

Masood

et al. 2023

Scandinavian Med Sci Sports

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BackgroundLower limb biomechanics, including asymmetry, are frequently monitored to determine sport performance level and injury risk. However, contributing factors extend beyond biomechanical and asymmetry measures to include psychological, sociological, and environmental factors. Unfortunately, inadequate research has been conducted using holistic biopsychosocial models to characterize sport performance and injury risk. Therefore, this scoping review summarized the research landscape of studies concurrently assessing measures of lower limb biomechanics, asymmetry, and introspective psychological state (e.g., pain, fatigue, perceived exertion, stress, etc.) in healthy, competitive athletes.MethodsA systematic search of MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science Core Collections was designed and conducted in accordance with PRISMA guidelines. Fifty‐one articles were included in this review.ResultsSignificant relationships between biomechanics (k = 22 studies) or asymmetry (k = 20 studies) and introspective state were found. Increased self‐reported pain was associated with decreased range of motion, strength, and increased lower limb asymmetry. Higher ratings of perceived exertion were related to increased lower limb asymmetry, self‐reported muscle soreness, and worse jump performance. Few studies (k = 4) monitored athletes longitudinally throughout one or more competitive season(s).ConclusionThis review highlights the need for concurrent analysis of introspective, psychological state, and biomechanical asymmetry measures along with longitudinal research to understand the contributing factors to sport performance and injury risk from biopsychosocial modeling. In doing so, this framework of biopsychosocial preventive and prognostic patient‐centered practices may provide an actionable means of optimizing health, well‐being, and sport performance in competitive athletes.

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Quadriceps muscle strength at 2 years following anterior cruciate ligament reconstruction is associated with tibiofemoral joint cartilage volume

Hipsley

Hall

Saxby

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeQuadriceps strength deficits following anterior cruciate ligament reconstruction (ACLR) are linked to altered lower extremity biomechanics, tibiofemoral joint (TFJ) space narrowing and cartilage composition changes. It is unknown, however, if quadriceps strength is associated with cartilage volume in the early years following ACLR prior to the onset of posttraumatic osteoarthritis (OA) development. The purpose of this cross‐sectional study was to examine the relationship between quadriceps muscle strength (peak and across the functional range of knee flexion) and cartilage volume at ~ 2 years following ACLR and determine the influence of concomitant meniscal pathology. MethodsThe involved limb of 51 ACLR participants (31 isolated ACLR; 20 combined meniscal pathology) aged 18–40 years were tested at 2.4 ± 0.4 years post‐surgery. Isokinetic knee extension torque generated in 10° intervals between 60° and 10° knee flexion (i.e. 60°–50°, 50°–40°, 40°–30°, 30°–20°, 20°–10°) together with peak extension torque were measured. Tibial and patellar cartilage volumes were measured using magnetic resonance imaging (MRI). The relationships between peak and angle‐specific knee extension torque and MRI‐derived cartilage volumes were evaluated using multiple linear regression. ResultsIn ACLR participants with and without meniscal pathology, higher knee extension torques at 60°–50° and 50°–40° knee flexion were negatively associated with medial tibial cartilage volume (p < 0.05). No significant associations were identified between peak concentric or angle‐specific knee extension torques and patellar cartilage volume. ConclusionHigher quadriceps strength at knee flexion angles of 60°–40° was associated with lower cartilage volume on the medial tibia ~ 2 years following ACLR with and without concomitant meniscal injury. Regaining quadriceps strength across important functional ranges of knee flexion after ACLR may reduce the likelihood of developing early TFJ cartilage degenerative changes. Level of evidenceIII.

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Quadriceps Torque, Peak Variability and Strength Endurance in Patients after Anterior Cruciate Ligament Reconstruction: Impact of Local Muscle Fatigue

Cited by 6 publications

References 38 publications

Impaired Regulation of Submaximal Force after ACL Reconstruction: Role of Muscle Spindles

Impaired Regulation of Submaximal Force after ACL Reconstruction: Role of Muscle Spindles

Monitoring lower limb biomechanical asymmetry and psychological measures in athletic populations—A scoping review

Quadriceps muscle strength at 2 years following anterior cruciate ligament reconstruction is associated with tibiofemoral joint cartilage volume

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