Evidence for differential control of tibial position in perturbed unilateral stance after acute ACL rupture
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作者:
Chmielewski, TL
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机构:Univ Delaware, Dept Phys Therapy, Grad Program Biomech & Movement Sci, Mckinly Lab 301, Newark, DE 19716 USA
Chmielewski, TL
Ramsey, DK
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机构:Univ Delaware, Dept Phys Therapy, Grad Program Biomech & Movement Sci, Mckinly Lab 301, Newark, DE 19716 USA
Ramsey, DK
Snyder-Mackler, L
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Univ Delaware, Dept Phys Therapy, Grad Program Biomech & Movement Sci, Mckinly Lab 301, Newark, DE 19716 USAUniv Delaware, Dept Phys Therapy, Grad Program Biomech & Movement Sci, Mckinly Lab 301, Newark, DE 19716 USA
Snyder-Mackler, L
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机构:
[1] Univ Delaware, Dept Phys Therapy, Grad Program Biomech & Movement Sci, Mckinly Lab 301, Newark, DE 19716 USA
[2] Univ Delaware, Biomed Engn Res Ctr, Mckinly Lab 301, Newark, DE 19716 USA
Functional outcomes in anterior cruciate ligament-deficient "potential copers" and "non-copers" may be related to their knee stabilization strategies. Therefore, the purpose of this study was to differentiate dynamic knee stabilization strategies of potential copers and non-copers through analysis of sagittal plane knee angle and tibia position during disturbed and undisturbed unilateral standing. Ten uninjured potential coper and non-coper subjects stood in unilateral stance on a platform that translated anteriorly, posteriorly and laterally. Knee angle and tibia position with reference to the femur were calculated before and after platform movement. During perturbation trials, potential copers maintained kinematics that were similar to uninjured subjects across conditions. Conversely, non-copers stood with greater knee flexion than uninjured subjects and a tibia position that was more posterior than the other groups. Both non-copers and potential copers demonstrated small changes in tibia position following platform movement, but direction of movement was not similar. The similarities between the knee kinematics of potential copers and uninjured subjects Suggest that potential copers compensated well from their injury by utilizing analogous dynamic knee stabilization strategies. In comparison to the other groups, by keeping the knee in greater flexion and the tibia in a more posterior position, non-copers appear to constrain the tibia in response to a challenging task, which is consistent with a "stiffening strategy". Based on the poor functional outcomes of non-copers, a stiffening strategy does not lead to dynamic knee stability, and the strategy may increase compressive forces which could contribute to or exacerbate articular cartilage degeneration. (C) 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.