Decoupling speed matters: Optimizing gait mechanics after anterior cruciate ligament reconstruction with Split-belt adaptation training of the healthy leg

IF 1.8 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2026-05-15 DOI:10.1016/j.clinbiomech.2026.106872

Alfred J. Crone , Alexa K. Johnson , Reagan Recchia , Abdulhamit Tayfur , Edward M. Wojtys , Chandramouli Krishnan , Riann M. Palmieri-Smith , ATC

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引用次数: 0

Abstract

Background

Knee and limb underloading are common problems after anterior cruciate ligament (ACL) reconstruction associated with early-onset osteoarthritis. Split-belt treadmill training is a promising method to address knee/limb underloading, but the dose-response relationship and its efficacy to target underloading after reconstruction remain unknown. Here, we examined if split-belt treadmill training of the healthy limb (i.e., modifying belt speed under this limb) affects ACL knee/limb loading.

Methods

Twenty-five participants with ACL reconstruction (Age: 23.24 ± 6.48 yr, Height: 1.73 ± 0.08 m, Mass: 76.08 ± 13.72 kg, Postoperative Time: 8.04 ± 1.78 months) were evaluated utilizing an instrumented treadmill synced with a 12-camera motion capture system. Participants completed 5 min of baseline walking with belts tied at 1.1 m/s. Belt speed under the healthy limb was then manipulated with eight, randomized 5-min decoupled speed configurations (30–170% of 1.1 m/s in 20% increments) with 2 min of tied-belt walking after each speed. Sagittal plane knee moments, angles, and vertical ground reaction forces were measured, and one-dimensional statistical parametric mapping was used to compare dependent variables between legs and decoupling speeds during stance.

Findings

A dose-response relationship was found where faster speeds increased ACL knee/limb loads throughout stance and slower speeds decreased them. In the healthy limb, faster speeds led to increased early stance and decreased midstance loading, with the opposite effect at slower speeds.

Interpretation

Our findings suggest that split-belt treadmill training the healthy limb at faster speeds may improve ACL knee/limb loading, but further research is needed to obtain a clear understanding of how this transfers to overground walking.

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解耦速度问题：健康腿劈裂带适应性训练前交叉韧带重建后的步态力学优化

背景：膝关节和肢体负荷不足是早发性骨关节炎前交叉韧带（ACL）重建后的常见问题。分带跑步机训练是解决膝关节/肢体负荷不足的一种很有前途的方法，但其剂量-反应关系及其对重建后目标负荷的有效性尚不清楚。在这里，我们检查了健康肢体的分离带跑步机训练（即改变该肢体下的带速）是否会影响前交叉韧带膝关节/肢体负荷。MethodsTwenty-five参与者与ACL重建(年龄:23.24 ±6.48  年,高度:1.73 ±0.08  m,质量:76.08 ±13.72  公斤,术后时间:8.04 ±  1.78个月)进行评估利用一个仪器的跑步机同步12-camera动作捕捉系统。参与者在1.1 米/秒的速度下完成5 分钟的基线步行。然后，在健康肢体下，采用8种随机的5分钟解耦速度配置（1.1 m/s的30-170%，以20%的速度增加）来控制皮带速度，并在每个速度后进行2 分钟的系带行走。测量了矢状面膝关节力矩、角度和垂直地面反作用力，并使用一维统计参数映射来比较站立时腿部和解耦速度之间的因变量。发现了剂量-反应关系，在整个站立过程中，更快的速度增加了前交叉韧带膝关节/肢体负荷，而更慢的速度则减少了负荷。在健康的肢体中，更快的速度会增加早期站姿和减少中站负荷，而在较慢的速度下则相反。我们的研究结果表明，以更快的速度训练健康肢体的分带跑步机可能会改善前交叉韧带膝盖/肢体的负荷，但需要进一步的研究来清楚地了解这如何转移到地上行走。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.