Sport Biomechanics: Impact of prior anterior cruciate ligament injury on inter-limb coordination of the lower extremities during bilateral strength exercises

In scientific literature, we can find some studies that have applied nonlinear techniques to injured individuals [1], [2], [3] but there is no common proposal on which measurement tools to use and which signal to apply for these nonlinear analyses. There has also been no application to the calculation of asymmetries between limbs, and furthermore, the assessment exercises are analytical, such as walking, running, or isometric exercises, which are very detached from sports movements. However, there seems to be a common thread: when there is a disturbance in biological systems, they tend to reduce their movement variability, becoming rigid and decreasing their degrees of motor freedom. In terms of linear analysis, there are numerous references that analyze the asymmetry between the injured and non-injured leg, with a clear consensus on the importance of having less than 5-10% asymmetry between limbs to establish medical clearance for sports [4]. However, this analysis is always based on linear calculation parameters such as jump height, average force, and peak force, among others. In this case, both dynamic and isometric exercises have been considered, with emphasis on those that closely mimic the specific movements involved in the sport [4], [5], [6], [7].  

 
[1]         J. Quirino et al., “Runners with a history of injury have greater lower limb movement regularity than runners without a history of injury,” Sports Biomech, pp. 1–13, 2021.

[2]         L. M. Decker, C. Moraiti, N. Stergiou, and A. D. Georgoulis, “New insights into anterior cruciate ligament deficiency and reconstruction through the assessment of knee kinematic variability in terms of nonlinear dynamics,” Knee surgery, sports traumatology, arthroscopy, vol. 19, pp. 1620–1633, 2011.

[3]         W. A. F. van de Ven, J. Bosga, W. Hullegie, W. C. Verra, and R. G. J. Meulenbroek, “Inertial-Sensor-Based Monitoring of Sample Entropy and Peak Frequency Changes in Treadmill Walking during Recovery after Total Knee Arthroplasty,” Sensors, vol. 23, no. 10, p. 4968, 2023.

[4]         C. Bishop, A. Turner, O. Gonzalo-Skok, and P. Read, “Inter-limb asymmetry during rehabilitation understanding formulas and monitoring the" magnitude" and" direction",” Aspetar Sports Medicine Journal, vol. 9, no. 1, pp. 18–22, 2020.

[5]         M. Helme, J. Tee, S. Emmonds, and C. Low, “Does lower-limb asymmetry increase injury risk in sport? A systematic review,” Physical Therapy in Sport, vol. 49, pp. 204–213, 2021.

[6]         Y. Guan, S. S. D. Bredin, J. Taunton, Q. Jiang, N. Wu, and D. E. R. Warburton, “Association between inter-limb asymmetries in lower-limb functional performance and sport injury: a systematic review of prospective cohort studies,” J Clin Med, vol. 11, no. 2, p. 360, 2022.

[7]         A. O. Parkinson, C. L. Apps, J. G. Morris, C. T. Barnett, and M. G. C. Lewis, “The calculation, thresholds and reporting of inter-limb strength asymmetry: A systematic review,” J Sports Sci Med, vol. 20, no. 4, p. 594, 2021.

 

 

Supervisors: Simone Tassani,  Bruno Fernandez-Valdes Villa