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THE INFLUENCE OF GROUND REACTION FORCES AND KNEE KINEMATICS IN INDIVIDUALS WITH KINESIOPHOBIA POST-ACLR

Abstract

M. Braatz, W. Smith, J. Zhang. C.J. Wutzke

Gonzaga University, Spokane, WA

Anterior cruciate ligament (ACL) tears are common in active individuals with altered gait characteristics post ACL reconstruction. Compensatory movements such as greater loading rate of the contralateral knee and increased stiffness of affected knee occur following ACLR. Fear of reinjury (kinesiophobia) can cause changes in movement with compensatory muscle activation, however, the association between kinesiophobia and gait deviations is unclear. PURPOSE: To determine the influence of kinesiophobia on ground reaction force and knee kinematics in ACLR individuals. METHODS: Six individuals with surgically repaired ACL between 6 months and 3 years prior completed the Tampa Scale for Kinesiophobia (TSK) and the Tegner Activity Scale (TAS) to determine classification of kinesiophobia. A seven inertial sensor system were fitted to the lower extremities of participants. Following a dynamic warm-up of 5 minutes of walking at a self-selected pace (SPP) on the split-belt instrumented treadmill, participants completed a three-minute walking trial for SSP, 25% slower than SSP (SP) and 25% faster than SSP (FP) with a break between each trial. TSK and TAS scores were recorded as well as kinetic and kinematic data of the lower extremity. Repeated measures ANOVA was conducted to compare the kinetics and kinematics between the injured and healthy leg, and across different walking paces with an alpha value p< 0.05. Spearman’s rho correlational analysis was conducted to determine associations between TSK and time since surgery. RESULTS: A difference between maximum knee flexion/extension between SP (56.28±4.18) and SSP (59.70±3.21) approached significant (p=0.063). Differences in vertical loading rate (SP =17.48±1.91, SSP=22.65±.97, FP= 27.65±3.30, p=0.010), peak propulsion force (SP=0.06±0.02, SSP=0.05±0.01, FP=0.16±0.03, p<0.001), peak braking force (SP = 0.37±0.02, SSP=0.46±0.03, FP=0.38±0.05, p=0.039) were found across different walking paces. A negative correlation between score on TSK (39.8±3.8) and time since surgery (15.7±8.2 months) was found (r(4)=-0.90, p=0.015). CONCLUSIONS: Individuals showed no difference between legs for kinematic or GRFs, despite high rate of kinesiophobia. People may be reclaiming function in injured knees at a faster rate than they regain confidence.

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