Hip Extensor Weakness and Hip Displacement Angle During Gait in Post Anterior Cruciate Ligament Reconstruction Subjects: A Correlativestudy

Chatrajeet Das; Dev Anand; Deepmala Thakur1

1

Publication Date: 2024/11/19

Abstract: Background and Purpose of the Study: The anterior cruciate ligament reconstruction (ACLR) subject’s exhibit altered hip moment pattern during early stance suggesting that the hip doesn’t re- establish normal joint moment characteristics at 3 months post-surgery. Weak hip extensors and quadriceps of the injured leg could lead to reduced hip extension and therefore a reduced hip displacement angle (HDA), and step length.  Method: An observational correlative study was conducted at HOSMAT Hospital physiotherapy OPD with a Sample size of 30. Outcome measures used were Hip extension (HE), Hip extensor strength (HES) and Hip Displacement Angle (HDA).  Results: 30 subjects with a Mean (SD) age of 28.27 (±5.85) yrs. 1 female and 29 males were included. There was statistical significant difference in all 3 outcome measures (HE, HES and HDA) in affected side compared to un-affected side, using paired “t” test. Correlations among the normalized outcome measures were done using pearson’s correlation co-efficient. re =0.450 (p=0.013) for HE and HES, rs = 0.346 (p=0.061) for HES and HDA, ra = 0.328 (p=0.077) for HDA and HE. This study showed a weak correlation among the outcome measures.  Conclusion: In this study significant difference was appreciated in all the 3 outcome measures between affected and unaffected side. HE and HES was decreased in affected side compare to unaffected side after 3 weeks of ACLR and increase in HDA in the affected side. Statistical correlation among the outcome measures showed very weak correlation among them.

Keywords: Anterior Cruciate Ligament Reconstruction, Hip Extension, Hip Extensor Strength, Hip Displacement Angle, Gait.

DOI: https://doi.org/10.38124/ijisrt/IJISRT24OCT1691

PDF: https://ijirst.demo4.arinfotech.co/assets/upload/files/IJISRT24OCT1691.pdf

REFERENCES

  1. Kate Button, Robert van Deursen, Patricia Price, Recovery in functional non- copers following anterior cruciate ligament rupture as detected by gait kinematics. Physical Therapy in Sport 9 (2008) 97–104.
  2. Hiemstra LA, Webber S, MacDonald PB, Kriellaars DJ. Knee strength deficits after hamstring tendon and patellar tendon anterior cruciate ligament reconstruction. Med Sci Sports Exerc. 2000;32:1472–1479.
  3. Bulgheroni P, Bulgheroni MV, Andrini L, Guffanti P, Giughello A. Gait patterns after anterior cruciate ligament reconstruction. Knee Surg Sport Traum Arthr 1997;5:14-21.
  4. Bush-Joseph CA, Hurwitz DE, Patel RR, Bahrani Y, Garretson R, Bach BR, et al. Dynamic function after anterior cruciate ligament reconstruction with autologous patellar tendon. Am J Sports Med 2001;29(1):36–41.
  5. Devita P, Hortobagyi T, Barrier J. Gait adaptations before and after anterior cruciate ligament reconstruction surgery. Med Sci Sports Exerc 1997;29:853– 9.
  6. Timoney JM, Inman WS, Quesada PM, Sharkey PF, Barrack RL, Skinner HB, et al. Return of normal gait patterns after anterior cruciate ligament reconstruction. Am J Sports Med 1993;21(6):887–9.
  7. Allison S. Arnold , Frank C. Anderson, Marcus G. Pandy, Scott L. Delp,
  8. Muscular contributions to hip and knee extension during the single limb stance phase of normal gait: a framework for investigating the causes of crouch gait. J Biomech 2005; 38 2181–2189.
  9. Neptune, R.R., Zajac, F.E., Kautz, S.A.,. Muscle force redistributes segmental power for body progression during walking. Gait Posture 2004;19, 194–205.
  10. Laurie A. Hiemstra, MD, PhD, FRCS(C),Wade T. Gofton, MD, and Dean J.
  11. Kriellaars, PhD, Hip Strength Following Hamstring Tendon Anterior Cruciate Ligament Reconstruction. Clin J Sport Med, Volume 15, Number 3, May 2005.
  12. Massimo Bacchini, Carola Cademartiri, Giovanni Soncini Gait analysis in patients undergoing ACL reconstruction according to Kenneth Jones’technique. ACTA BIOMED 2009; 80: 140-149.
  13. Michael D. Ross, The relationship between functional levels and fear- avoidance beliefs following anterior cruciate ligament reconstruction. J Orthopaed Traumatol (2010) 11:237–243.
  14. Judith M. Burnfield, PT, Karen R. Josephson, MPH, Christopher M. Powers, PhD, PT,Laurence Z. Rubenstein, MD, MPH, The Influence of Lower Extremity Joint Torque on Gait Characteristics in Elderly Men. Arch Phys Med Rehabil Vol 81, September 2000.