Article

The temporal structure of gait variability has shown that healthy
human gait exhibits long-range correlations and deterministic properties which
allow the neuromuscular system to be flexible and adaptable to stresses.
Pathology results in deterioration of these properties. We examined structure of
gait variability after ACL reconstruction with either BPTB or quadrupled ST/G
tendon autografts. METHODS: Six patients with BPTB reconstruction, six with ST/G
reconstruction and six healthy controls walked on a treadmill at their
self-selected pace. Two minutes of continuous kinematic data were recorded with a
6-camera optoelectronic system. The nonlinear measure of the largest Lyapunov
Exponent (LyE) was estimated from the knee flexion-extension time series from 100
continuous walking strides to assess the structure of gait variability. RESULTS:
The reconstructed limbs in both reconstructed groups exhibited significantly
larger LyE values than the control limbs (p<0.05), even though clinical outcomes
indicated complete restoration. No significant differences were found between the
two autografts. In addition, the intact contralateral leg produced significant
higher LyE values as compared with the ACL-reconstructed leg in both groups. No
interaction was found. DISCUSSION: The larger LyE values indicate that the
reconstructed knees of both reconstructed groups exhibit more divergence in the
movement trajectories during gait. The larger Lye values found in the intact leg
in both reconstructed groups could be interpreted as a compensatory mechanism.
However, the increased divergence found in both limbs may present an alternative
explanation for the impaired neuromuscular performance and increased
susceptibility to future pathology, which is supported by the increased amount of
osteoarthritis found in ACL-reconstructed patients.
CI - Copyright 2010 Elsevier B.V. All rights reserved.

Langue : ANGLAIS