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Knee Kinematics and Joint Moments During Stair Negotiation in Participants With Anterior Cruciate Ligament Deficiency and Reconstruction

HAJIZADEH M; HASHEMI OSKOUEI A; GHALICHI F; SOLE G
PM & R , 2016, vol. 8, n° 6, p. 563-579
Doc n°: 179054
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.pmrj.2016.01.014
Descripteurs : DE562 - TRAITEMENT DE REEDUCATION - GENOU

OBJECTIVE: Biomechanical changes have been reported for patients with anterior
cruciate ligament deficiency (ACLD) and anterior cruciate ligament (ACL
reconstruction) (ACLR), likely due to loss of stability and changes in
proprioception and neuromotor control. This review evaluated kinematics and
kinetics of ACLD and ACLR knees, compared with those on the contralateral
uninjured sides, as well as and those in asymptomatic controls during stair
navigation. DESIGN: This is a systematic review and meta-analysis. LITERATURE
SURVEY: Electronic database searches were conducted from their original available
dates to January 2015. Studies that included participants with ACLD or ACLR and
reported knee joint angles or moments during stair ascent or descent were
included. METHODOLOGY: Nine studies met the inclusion criteria, and the
methodological quality of these was assessed with a modified Downs and Black
checklist. Effect sizes for differences between injured leg and uninjured
contralateral leg or controls were calculated, and meta-analyses were performed
if two or more studies considered the same variable. SYNTHESIS: Quality
assessment showed an average (+/- standard deviation) of 70.3% +/- 7.2%.
Meta-analysis showed less knee flexion at initial contact for ACLR knees compared
with that in contralateral knees during stair ascent, with a moderate effect size
and minimal heterogeneity. Knees with ACLD showed less peak knee flexion compared
with that on contralateral sides during stair ascent, with minimal heterogeneity.
External knee flexion moments were lower for ACLR compared with those in controls
and contralateral sides during ascent and descent, whereas these moments were
decreased for the ACLD compared with controls only during ascent. Meta-analysis
results exhibited moderate/high heterogeneity or small/trivial effect sizes.
CONCLUSIONS: Differences for kinematics and kinetics for the ACL-injured knees
indicate long-term compensatory and asymmetric movement patterns while ascending
and descending stairs. Due to the heterogeneity as well as the small numbers of
available studies, the consequences of these differences in terms of long-term
function or posttraumatic osteoarthritis need further exploration.
CI - Copyright (c) 2016. Published by Elsevier Inc.

Langue : ANGLAIS

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