Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
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©Journal of Sports Science and Medicine (2010) 09, 472 - 479

Research article
Alterations of Kinetic Characteristics in Step Up and Over Test in Patients with Anterior Cruciate Ligament Deficiency
Hsiu-Chen Lin1,2, Horng-Chaung Hsu3,4, Chia-Ming Chang2, Pei-Wen Chiou4,5, Tung-Wu Lu1, 
Author Information
1 Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, R.O.C.
2 China Medical University, Taichung, Taiwan, R.O.C.
3 China Medical University Hospital, Taichung, Taiwan, R.O.C.
4 Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C.
5 Department of Rehabilitation, Lotung Poh-Ai Hospital, Yilan, Taiwan, R.O.C.

Tung-Wu Lu
‚úČ Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 1, Jen-Ai Road, Taipei 100, Taiwan, R.O.C.
Email: twlu@ntu.edu.tw
Publish Date
Received: 24-03-2010
Accepted: 14-07-2010
Published (online): 01-09-2010
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ABSTRACT

The purpose of this study is to investigate the alterations of kinetic characteristics in the step up/over test in patients with acute and chronic anterior cruciate ligament (ACL) deficiency. Twenty acute, twenty chronic ACL-deficient (ACLD) patients, and forty healthy controls participated in this study. The step up/over test was performed on a clinical force platform system to obtain the following variables: movement time, lift-up index and impact index. The percentages of the indexes from the stepping leg and time of step-up and swing- over were further calculated. These variables were examined statistically by using mixed repeated measure analysis of variance to reveal the differences between groups and between limbs. Smaller lift-up forces and longer swing-over time in both ACLD groups than those in the control group were found. One exception was the lift-up index in the affected side condition of the acute ACLD group, which was not significantly different from the controls. A reduced contribution to the impact index from the affected stepping leg was also found in the acute ACLD group. The acute ACLD group showed no significant change in their step-up strategy at the affected limbs, but they may have a poorer eccentric control of the affected knees on the step and thus put a larger portion of loading onto the unaffected landing leg. Our results indicated the lift-up index, swing-over time and load- distributing strategy at impact may be important parameters in monitoring functional recovery in patients with ACL deficiency. The detected alterations in these parameters could be used as a reference to design proper rehabilitation exercises for these patients.

Key words: Knee, ACL deficiency, kinetics, locomotion, step activity


           Key Points
  • The lift-up index and the time of swing-over could be important parameters for indentifying functional impairments in patients with ACL deficiency.
  • The differences between limbs were found only in the acute ACLD group with a larger lift-up index and smaller load-distribution at impact on the affected limb.
  • The step up/over test on the clinical force platform system could be helpful in providing a reference to design proper rehabilitation exercise and to monitor the recovery of the functional ability in patients with ACL deficiency.
 
 
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