Recovery in functional non-copers following anterior cruciate ligament rupture as detected by gait kinematics

Abstract 

Objectives

To evaluate if gait compensation strategies for selected kinematic variables can be identified in anterior cruciate ligament (ACL) deficient non-copers using two-dimensional (2D) clinical gait analysis.

Design

Prospective observational design, repeated measures.

Setting

University hospital, out-patients department.

Patients

Sixty-three patients that attended the acute knee screening service were diagnosed with an acute ACL rupture and consented to participate. A sub-set of 15 copers/adapters and 13 non-copers were eligible for final analysis because they were contactable for sub-classification and had gait analysis at 1 and 4 months post-injury.

Main outcome measures

2D video gait analysis for sagittal plane hip, knee and ankle kinematics and time–distance variables.

Results

At 4 months post-injury non-copers demonstrated significantly less recovery of knee angle (F_(1,1)=5.79, p<0.024), hip displacement angle (F_(1,1)=4.89, p<0.036), step length (F_(1,1) =6.80, p=0.015), cadence (F_(1,1)=5.85, p=0.023) and velocity (F_(1,1)=10.89, p=0.003), compared to copers/adapters. Also non-copers demonstrated altered correlations between gait parameters.

Conclusion

At 4 months post-injury non-copers had an inferior gait performance compared to copers/adapters for kinematics and time–distance variables. 2D clinical kinematic gait analysis, particularly of the hip and knee can inform early rehabilitation techniques and monitor recovery.

Keywords: Anterior crucuate ligament rupture, Gait, Video analysis, Rehabilitation, Kinematics