Article

The posterior cruciate ligament (PCL) plays an important role in the structural
stability and sensory feedback at the knee. Altered structural and proprioceptive
function at the PCL-deficient knee may affect the joint motions and the end-point
control during functional activities. The current study identified the effects of
unilateral PCL deficiency (PCLD) on the end-point control and joint kinematics of
the lower limbs during obstacle-crossing. Eighteen patients with unilateral PCLD
and eighteen healthy controls were each asked to walk and cross obstacles of
heights of 10%, 20% and 30% of their leg lengths, with the affected and the
unaffected limb leading, while their kinematic data were measured. Patients with
PCLD were found to cross obstacles with significantly increased toe-clearance
(p<0.01), increased trailing toe-obstacle distance (p<0.05) and reduced crossing
speed (p<0.01) when compared to the controls. Similar end-point control was
observed in the PCLD group whether leading with the affected or unaffected limb,
which appears to be as a result of bilateral kinematic accommodation to reduce
the risk of tripping. To achieve similar toe-clearances, crossing strategies with
the unaffected limb leading involved angular changes at more joints than those
with the affected limb leading. The PCLD group appeared to adopt a conservative
strategy to reduce the risk of tripping over the obstacle during
obstacle-crossing, using different joint kinematic changes depending on whether
the affected or unaffected limb was leading. It is suggested that monitoring of
the kinematic strategies adopted by patients with PCLD during obstacle-crossing
may be needed in future rehabilitation programs with the aim of reducing tripping
risks during obstacle-crossing.
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Langue : ANGLAIS