Purpose
The purpose of this study was to determine 1) whether progressive functional resistance
training (FRT) during walking would improve knee biomechanical symmetry after anterior
cruciate ligament (ACL) reconstruction and 2) whether the mode of delivery of FRT
would have a differential effect on symmetry.
Methods
Thirty individuals who underwent primary ACL reconstruction at a single institution
volunteered for this study. Participants were randomized into one of three groups:
1) BRACE, 2) BAND, or 3) CONTROL. The BRACE group received FRT with a novel robotic
knee brace along with real-time kinematic feedback. The BAND group received FRT with
a custom resistance band device along with real-time kinematic feedback. The CONTROL
group received only real-time kinematic feedback. Participants in all groups received
training (2-3/week for 8 weeks) while walking on a treadmill. Knee angle and moment
symmetry were calculated immediately prior to beginning the intervention and within
1 week of completing the intervention. Statistical Parametric Mapping was used to
assess differences in biomechanical symmetry between groups across time.
Results
There was a significant interaction in knee moment symmetry from 21 and 24% of the
stance phase (P = .046), in which the BAND group had greater improvements following training compared
with both BRACE (P = .043) and CONTROL groups (P = .002). There was also a significant time effect in knee angle symmetry from 68
to 79% of the stance phase (P = .028) and from 97 to 100% of the swing phase (P = .050) in which only the BRACE group showed significant improvements after the intervention
(stance: P = .020 and swing: P < .001).
Conclusion
The results of this randomized controlled clinical trial indicate that 8 weeks of
progressive FRT during treadmill walking in individuals with ACL reconstruction improves
knee angle and moment symmetry during gait. The findings suggest that FRT could serve
as a potential therapeutic adjuvant to traditional rehabilitation after ACL reconstruction
and can help restore knee joint biomechanical symmetry.
Level of Evidence
Level II, randomized controlled trial.
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Article Info
Publication History
Published online: June 08, 2022
Accepted:
April 27,
2022
Received:
November 11,
2021
Footnotes
See commentary on page 3056
The authors report the following potential conflicts of interest or sources of funding: R.M.P.-S. reports grants from National Institutes of Health , during the conduct of the study. C.K. reports grants from National Institutes of Health , during the conduct of the study. In addition, Dr. Krishnan has a patent US20210205651A1 issued. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2022 by the Arthroscopy Association of North America
