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Background: With grade 3 posterolateral injuries of the knee, reconstructions of the lateral collateral ligament, popliteus tendon, and popliteofibular ligament are commonly performed in conjunction with a posterior cruciate ligament [...]

Underloading the surgical limb has been described in biomechanical studies across recovery time points following anterior cruciate ligament reconstruction (ACLr). This study aimed to examine the extent to which laboratory findings translate to daily activities. Limb loading was quantified during a sit‐to‐stand task in laboratory testing and throughout 2 days of daily activity in 15 individuals 114.8 (17.2) days post‐ACLr and 15 controls. Vertical force impulse calculated from force platform (laboratory) and pressure insoles (daily) was used to quantify limb loading. Between‐limb symmetry was calculated for limb loading and knee strength measures, 2 × 2 GLM repeated measures determined a significant group‐by‐limb interaction on daily limb loading. Surgical limb daily loading was lower compared to nonsurgical (p <.001; effect sizes [ES] = 0.63), and control matched limbs (surgical: p =.037, ES = 0.80 and nonsurgical: p =.02, ES = 0.89). No group differences were found in total daily loading (summed loading between limbs; p =.18; ES = 0.50) and time performing weight‐bearing activities (p =.32; ES = 0.36). Pearson's correlation determined that between‐limb symmetry in daily loading was related to sit‐to‐stand loading (r =.62; p =.01) and knee extensor strength symmetry (r =.6; p =.02) in the ACLr group. These data support the presence of underloading behaviors in individuals 10–14 weeks following ACLr that are consistent with previous biomechanical studies and current biomechanical data. Knee extensor weakness was related to greater underloading. Asymmetrical loading quantified in the laboratory is practiced throughout the day in individuals post‐ACLr. Practice afforded by daily activities represents powerful contributors to learning of a pattern that contrasts the goal of rehabilitation exercises. [ABSTRACT FROM AUTHOR]

Knee injuries are common in jumping athletes; modifying jump strategy may impact loads placed on the body and reduce injury risk. The purpose of this study was to determine if modifying strategy in a saut de chat leap to focus on height would decrease sagittal plane knee loading. Biomechanical data were collected while 28 dancers performed saut de chat leaps with instructions to jump far (FAR) or jump high (UP). In the UP condition, there was greater vertical GRF and less braking GRF. Also in UP, lower extremity contact angle was greater (71.3 ± 2.9º FAR; 75.8 ± 3.3º UP; p = 0.0178), peak knee extensor moment was greater (2.8 ± 0.7 Nm FAR; 3.2 ± 0.8 Nm UP; p = 0.01), and peak ankle plantar flexor moment was lower (3.19 ± 0.4 Nm FAR; 2.94 ± 0.4 Nm UP; p < 0.01). A more acute LECA was related to greater braking force and braking force was related to greater knee extensor moments. Despite these relationships, we observed greater knee extensor moments in UP. While the relationship among these whole-body variables and knee joint loading exists, it may not be the primary factor driving load distribution during dance leap landings. [ABSTRACT FROM AUTHOR]

Biomechanical studies consistently report smaller knee extensor moments in the surgical limb during loading response (LR) of gait following ACL reconstruction (ACLr). However, this reduction in knee loading is quantified by net joint moments (NJM). As a result, in the presence of greater hamstring activity, the true contribution from the knee extensors may not be reduced. The purpose of this study is to compare hamstring activity and strength and knee joint moments between individuals post‐ACLr and controls. Eighteen individuals 3 months post‐ACLr and matched controls walked and net knee extensor moment peak and impulse and hamstring activity were identified during LR, as well as maximal hamstring strength. A hybrid musculoskeletal model estimated knee flexor moments from joint kinematics and hamstring electromyography. Flexor moments (SIMM) were scaled based on strength. Knee extensor moments were estimated from the sum of the net knee moment and estimated knee flexor moment; estimated extensor moment peaks and impulse were calculated during LR. Repeated measures analysis of variance compared groups and limbs. Smaller net knee extensor moment and greater hamstring activity, as well as deficits in maximal hamstring strength, were observed in the surgical limb (all p < 0.05). When accounting for the torque‐producing capabilities of the knee flexors, estimated knee extensor moment peak and impulse were smaller in the surgical limb. These findings suggest that net knee moments accurately reflect smaller knee extensor loading post‐ACLr. Statement of Clinical Significance: Rehabilitation programs should target increasing knee extensor loading to restore gait mechanics during early rehabilitation. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:378‐386, 2020 [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the effects of practice on performance of a running task requiring maximal speed and accurate termination. Physically active pre-pubertal boys and men ran as fast as possible and stopped at a pre-determined target location. Twenty-five trials were collected and comparisons made between first five (early) and last five (late) trials. Approach velocity, normalized approach velocity (percent of maximal sprint velocity, %Vmax), stopping distance from target, and success rate were calculated. Self-efficacy for task performance and fatigue reports were collected prior to trials. Children ran more slowly than adults in absolute terms but performed at higher relative velocity. Both groups displayed similar accuracy and percentages of successful trials across early and late practice. Adults increased approach velocity and %Vmax from early to late; children, already higher in relative maximal velocity, did not change. Self-efficacy paralleled performance findings and correlated with %Vmax and success rate; both groups reported higher self-efficacy for late compared with early. With practice, adults increased approach velocity and children did not; however, children appeared to be performing at a higher relative level from the beginning, perhaps reflecting their more substantial recent histories of similar physical activity and limiting further effects of practice. [ABSTRACT FROM AUTHOR]