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Altered movement patterns and muscular activity during single and double leg squats in individuals with anterior cruciate ligament injury.

Trulsson, Anna LU ; Miller, Michael LU ; Hansson, Gert-Åke LU ; Gummesson, Christina LU and Garwicz, Martin LU (2015) In BMC Musculoskeletal Disorders 16.
Abstract
Background

Individuals with Anterior Cruciate Ligament (ACL) injury often show altered movement patterns, suggested to be partly due to impaired sensorimotor control. Here, we therefore aimed to assess muscular activity during movements often used in ACL-rehabilitation and to characterize associations between deviations in muscular activity and specific altered movement patterns, using and further exploring the previously developed Test for substitution Patterns (TSP).

Methods

Sixteen participants (10 women) with unilateral ACL rupture performed Single and Double Leg Squats (SLS; DLS). Altered movement patterns were scored according to TSP, and Surface Electromyography (SEMG) was recorded bilaterally in six hip,... (More)
Background

Individuals with Anterior Cruciate Ligament (ACL) injury often show altered movement patterns, suggested to be partly due to impaired sensorimotor control. Here, we therefore aimed to assess muscular activity during movements often used in ACL-rehabilitation and to characterize associations between deviations in muscular activity and specific altered movement patterns, using and further exploring the previously developed Test for substitution Patterns (TSP).

Methods

Sixteen participants (10 women) with unilateral ACL rupture performed Single and Double Leg Squats (SLS; DLS). Altered movement patterns were scored according to TSP, and Surface Electromyography (SEMG) was recorded bilaterally in six hip, thigh and shank muscles. To quantify deviations in muscular activity, SEMG ratios were calculated between homonymous muscles on injured and non-injured sides, and between antagonistic muscles on the same side. Correlations between deviations of injured/non-injured side SEMG ratios and specific altered movement patterns were calculated.

Results

Injured/non-injured ratios were low at transition from knee flexion to extension in quadriceps in SLS, and in quadriceps and hamstrings in DLS. On injured side, the quadriceps/hamstrings ratio prior to the beginning of DLS and end of DLS and SLS, and tibialis/gastrocnemius ratio at end of DLS were lower than on non-injured side. Correlations were found between specific altered movement patterns and deviating muscular activity at transition from knee flexion to extension in SLS, indicating that the more deviating the muscular activity on injured side, the more pronounced the altered movement pattern. “Knee medial to supporting foot” correlated to lower injured/non-injured ratios in gluteus medius (rs = −0.73, p = 0.001), “lateral displacement of hip-pelvis-region” to lower injured/non-injured ratios in quadriceps (rs = −0.54, p = 0.03) and “displacement of trunk” to higher injured/non-injured ratios in gluteus medius (rs = 0.62, p = 0.01).

Conclusions

Deviations in muscular activity between injured and non-injured sides and between antagonistic muscular activity within injured as compared to non-injured sides indicated specific alterations in sensorimotor control of the lower limb in individuals with ACL rupture. Also, correlations between deviating muscular activity and specific altered movement patterns were suggested as indications of altered sensorimotor control. We therefore advocate that quantitative assessments of altered movement patterns should be considered in ACL-rehabilitation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anterior cruciate ligament, Movement pattern, Muscular activity, Motor skills, Motor control, Single leg squat, Electromyography (EMG), Postural orientation, Assessment, Physiotherapy
in
BMC Musculoskeletal Disorders
volume
16
publisher
BioMed Central
external identifiers
  • pmid:25887306
  • scopus:84924241600
  • wos:000350387900003
  • other:DOI 10.1186/s12891-015-0472-y
ISSN
1471-2474
DOI
10.1186/s12891-015-0472-y
language
English
LU publication?
yes
id
a400e248-d807-4967-8e10-7fc49c79893a (old id 5341402)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25887306?dopt=Abstract
date added to LUP
2015-03-23 15:38:59
date last changed
2017-09-03 04:09:07
@article{a400e248-d807-4967-8e10-7fc49c79893a,
  abstract     = {Background<br/><br>
Individuals with Anterior Cruciate Ligament (ACL) injury often show altered movement patterns, suggested to be partly due to impaired sensorimotor control. Here, we therefore aimed to assess muscular activity during movements often used in ACL-rehabilitation and to characterize associations between deviations in muscular activity and specific altered movement patterns, using and further exploring the previously developed Test for substitution Patterns (TSP).<br/><br>
Methods<br/><br>
Sixteen participants (10 women) with unilateral ACL rupture performed Single and Double Leg Squats (SLS; DLS). Altered movement patterns were scored according to TSP, and Surface Electromyography (SEMG) was recorded bilaterally in six hip, thigh and shank muscles. To quantify deviations in muscular activity, SEMG ratios were calculated between homonymous muscles on injured and non-injured sides, and between antagonistic muscles on the same side. Correlations between deviations of injured/non-injured side SEMG ratios and specific altered movement patterns were calculated.<br/><br>
Results<br/><br>
Injured/non-injured ratios were low at transition from knee flexion to extension in quadriceps in SLS, and in quadriceps and hamstrings in DLS. On injured side, the quadriceps/hamstrings ratio prior to the beginning of DLS and end of DLS and SLS, and tibialis/gastrocnemius ratio at end of DLS were lower than on non-injured side. Correlations were found between specific altered movement patterns and deviating muscular activity at transition from knee flexion to extension in SLS, indicating that the more deviating the muscular activity on injured side, the more pronounced the altered movement pattern. “Knee medial to supporting foot” correlated to lower injured/non-injured ratios in gluteus medius (rs = −0.73, p = 0.001), “lateral displacement of hip-pelvis-region” to lower injured/non-injured ratios in quadriceps (rs = −0.54, p = 0.03) and “displacement of trunk” to higher injured/non-injured ratios in gluteus medius (rs = 0.62, p = 0.01).<br/><br>
Conclusions<br/><br>
Deviations in muscular activity between injured and non-injured sides and between antagonistic muscular activity within injured as compared to non-injured sides indicated specific alterations in sensorimotor control of the lower limb in individuals with ACL rupture. Also, correlations between deviating muscular activity and specific altered movement patterns were suggested as indications of altered sensorimotor control. We therefore advocate that quantitative assessments of altered movement patterns should be considered in ACL-rehabilitation.},
  articleno    = {28},
  author       = {Trulsson, Anna and Miller, Michael and Hansson, Gert-Åke and Gummesson, Christina and Garwicz, Martin},
  issn         = {1471-2474},
  keyword      = {Anterior cruciate ligament,Movement pattern,Muscular activity,Motor skills,Motor control,Single leg squat,Electromyography (EMG),Postural orientation,Assessment,Physiotherapy},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Musculoskeletal Disorders},
  title        = {Altered movement patterns and muscular activity during single and double leg squats in individuals with anterior cruciate ligament injury.},
  url          = {http://dx.doi.org/10.1186/s12891-015-0472-y},
  volume       = {16},
  year         = {2015},
}