Bilateral neuromuscular control in patients one year after unilateral ACL rupture or reconstruction. A cross-sectional study

Angela Blasimann; Aglaja Busch; Philipp Henle; Sven Bruhn; Dirk Vissers; Heiner Baur

doi:10.1016/j.heliyon.2024.e24364

Bilateral neuromuscular control in patients one year after unilateral ACL rupture or reconstruction. A cross-sectional study

Heliyon. 2024 Jan 11;10(2):e24364. doi: 10.1016/j.heliyon.2024.e24364. eCollection 2024 Jan 30.

Authors

Angela Blasimann^{1

2}, Aglaja Busch^{1

3}, Philipp Henle^{4

5}, Sven Bruhn⁶, Dirk Vissers², Heiner Baur¹

Affiliations

¹ Bern University of Applied Sciences, School of Health Professions, Division of Physiotherapy, 3008, Bern, Switzerland.
² University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, 2610, Wilrijk, Belgium.
³ University of Potsdam, University Outpatient Clinic, Sports Medicine & Sports Orthopedics, 14469, Potsdam, Germany.
⁴ Lindenhof Group AG, Sonnenhof Orthopaedic Center, 3006, Bern, Switzerland.
⁵ University of Bern, Bern University Hospital, Inselspital, Department of Orthopaedic Surgery and Traumatology, 3010, Bern, Switzerland.
⁶ University of Rostock, Institute of Sports Science, 18051, Rostock, Germany.

Abstract

Objectives: To compare bilateral neuromuscular control in patients one year after anterior cruciate ligament reconstruction (ACL-R) or conservative treatment (ACL-C) to healthy controls (ACL-I).

Design: Cross-sectional study.

Setting: Electromyography of vastus medialis (VM) and lateralis (VL), biceps femoris (BF) and semitendinosus (ST) was recorded during stair descent and anterior tibial translation. Each step of stair descent was divided into pre-activity, weight-acceptance and push-off phase. Pre-activation, short, medium (MLR) and long latency responses (LLR) were defined for reflex activity.

Participants: N = 38 patients one year after ACL reconstruction (ACL-R), N = 26 participants with conservative treatment one year after ACL rupture (ACL-C), N = 38 healthy controls with an intact ACL (ACL-I).

Main outcome measures: Normalized root mean squares per muscle and phase (α = 0.05).

Results: During stair descent, within-group leg differences were found for the quadriceps in ACL-R during all phases and for the BF in ACL-C during weight-acceptance. Between-group leg differences were found for BF in both patient groups compared to ACL-I during push-off.Between-group differences in pre-activation for VM between ACL-R and ACL-C, and between ACL-C and ACL-I were found, and as LLR between patients and ACL-R versus ACL-I. Pre-activation of BF and MLR of ST differed for each patient group compared to ACL-I.

Conclusions: Bilateral neuromuscular alterations are still present one year after ACL rupture or reconstruction.

Keywords: ACL; Anterior cruciate ligament; Conservative treatment; EMG; Electromyography; Knee injuries; Neuromuscular control; Physiotherapy; Reconstruction; Rehabilitation.