Individuals early after anterior cruciate ligament reconstruction show intact motor learning of step length via the split-belt treadmill

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2024-04-23 DOI:10.1016/j.clinbiomech.2024.106256

Elanna K. Arhos , Jonathan M. Wood , Karin Grävare Silbernagel , Susanne M. Morton

{"title":"Individuals early after anterior cruciate ligament reconstruction show intact motor learning of step length via the split-belt treadmill","authors":"Elanna K. Arhos , Jonathan M. Wood , Karin Grävare Silbernagel , Susanne M. Morton","doi":"10.1016/j.clinbiomech.2024.106256","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Rupturing the anterior cruciate ligament is an orthopedic injury that results in neuromuscular impairments affecting sensory input to the central nervous system. Traditional physical therapy after anterior cruciate ligament reconstruction aims to rehabilitate orthopedic impairments but fails to address asymmetric gait mechanics that are present post-operatively and are linked to the development of post-traumatic osteoarthritis. A first step towards developing gait interventions is understanding if individuals after anterior cruciate ligament reconstruction have the capacity to learn new walking mechanics.</p></div><div><h3>Methods</h3><p>The split-belt treadmill offers a task-specific approach to examine neuromuscular adaptations in patients after injury. The potential for changing spatiotemporal gait mechanics via split-belt treadmill adaptation has not been tested early after anterior cruciate ligament reconstruction; nor has the ability to retain and transfer newly learned gait mechanics. Therefore, we used a split-belt treadmill paradigm to compare gait adaptation, retention, and transfer to overground walking between 15 individuals 3–9 months after anterior cruciate ligament reconstruction and 15 matched control individuals.</p></div><div><h3>Findings</h3><p>Results suggested individuals after anterior cruciate ligament reconstruction were able to adapt and retain step length symmetry changes as well as controls. There was also evidence of partial transfer to overground walking, similar to controls.</p></div><div><h3>Interpretation</h3><p>Despite disruption in afferent feedback from the joint, individuals early after anterior cruciate ligament reconstruction can learn a new gait pattern using sensorimotor adaptation, retain, and partially transfer the learned gait pattern. This may be a critical time to intervene with gait-specific interventions targeting post-operative gait asymmetries.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0268003324000883/pdfft?md5=59a872b8ca43bf65038bc3a16f0b790c&pid=1-s2.0-S0268003324000883-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268003324000883","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Rupturing the anterior cruciate ligament is an orthopedic injury that results in neuromuscular impairments affecting sensory input to the central nervous system. Traditional physical therapy after anterior cruciate ligament reconstruction aims to rehabilitate orthopedic impairments but fails to address asymmetric gait mechanics that are present post-operatively and are linked to the development of post-traumatic osteoarthritis. A first step towards developing gait interventions is understanding if individuals after anterior cruciate ligament reconstruction have the capacity to learn new walking mechanics.

Methods

The split-belt treadmill offers a task-specific approach to examine neuromuscular adaptations in patients after injury. The potential for changing spatiotemporal gait mechanics via split-belt treadmill adaptation has not been tested early after anterior cruciate ligament reconstruction; nor has the ability to retain and transfer newly learned gait mechanics. Therefore, we used a split-belt treadmill paradigm to compare gait adaptation, retention, and transfer to overground walking between 15 individuals 3–9 months after anterior cruciate ligament reconstruction and 15 matched control individuals.

Findings

Results suggested individuals after anterior cruciate ligament reconstruction were able to adapt and retain step length symmetry changes as well as controls. There was also evidence of partial transfer to overground walking, similar to controls.

Interpretation

Despite disruption in afferent feedback from the joint, individuals early after anterior cruciate ligament reconstruction can learn a new gait pattern using sensorimotor adaptation, retain, and partially transfer the learned gait pattern. This may be a critical time to intervene with gait-specific interventions targeting post-operative gait asymmetries.

查看原文本刊更多论文

前十字韧带重建后的早期患者通过分带跑步机对步长进行完整的运动学习

背景前十字韧带断裂是一种骨科损伤，会导致神经肌肉损伤，影响中枢神经系统的感觉输入。前十字韧带重建后的传统物理治疗旨在恢复矫形损伤，但未能解决术后出现的不对称步态力学问题，而这种不对称步态力学与创伤后骨关节炎的发展有关。开发步态干预措施的第一步是了解前交叉韧带重建后的患者是否有能力学习新的步行力学。在前交叉韧带重建后的早期，还没有测试过通过分带跑步机适应改变时空步态力学的潜力；也没有测试过保留和转移新学步态力学的能力。因此，我们使用分带跑步机范例，比较了 15 名前交叉韧带重建后 3-9 个月的个体和 15 名匹配的对照组个体的步态适应、保留和转移到地面行走的情况。结果结果表明，前交叉韧带重建后的个体与对照组一样能够适应和保留步长对称性变化。尽管来自关节的传入反馈受到干扰，但前交叉韧带重建后早期的个体可以通过感觉运动适应来学习新的步态模式，保留并部分转移所学的步态模式。这可能是针对术后步态不对称进行特定步态干预的关键时刻。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.