Kinematics and muscular responses to a ramp descent in the ACL deficient knee

Descent of a ramp has been shown to induce large anterior shear forces on the knee joint. Compensatory muscle responses observed in individuals following an anterior cruciate ligament (ACL) injury are believed to be adopted for the purpose of reducing these forces at the knee, in the absence of the mechanical restraint previously provided by the ACL. As such, examining the kinematics and muscle responses of ACL deficient individuals during ramp descent may provide further insight into strategies used by this population to compensate for anterior shear forces at the knee.

Eight ACL deficient individuals were studied, in comparison to a healthy CONTROL group (N=8), during the descent of a 20 degrees ramp. Kinematics and electromyography were recorded for the injured lower limb of ACLD and matched limb of healthy control individuals.

ACLD individuals produced altered knee kinematics at heel contact only. Knee motion through stance and swing were similar to CONTROL individuals. ACLD individuals produced significantly greater vastus lateralis and gastrocnemius total muscle activity, but decreased total biceps femoris activity. No significant differences were observed for the timing of peak muscle activity or the magnitude at this point between ACLD and CONTROL.

Greater total muscle activity of vastus lateralis implies that greater force contributions from this muscle were used by ACLD in comparison to CONTROL in response to the ramp. These observations reinforce that quadriceps avoidance is not used by ACLD individuals to reduce anterior shear forces at the knee joint. Rather, vastus lateralis may be used to reduce internal tibial rotation in extreme loading situations.