Using force sensing insoles to predict kinetic knee symmetry during a stop jump

Knee kinetic asymmetries are present during jump-landings in athletes returning to sport following anterior cruciate ligament (ACL) reconstruction, and are associated with an increased risk for sustaining a second ACL injury. The loadsol® is a wireless load sensing insole that can be used in non-laboratory settings. The purpose of this study was to determine if the loadsol® could be used to predict knee extension moment and power symmetry during a bilateral stop jump task in healthy recreational athletes. Forty-two uninjured recreational athletes completed seven bilateral stop jumps. During each landing, the loadsol® (100 Hz) measured plantar load while 3D ground reaction forces (1920 Hz) and lower extremity kinematics (240 Hz) were collected simultaneously. Peak impact force, loading rate, and impulse were quantified using the loadsol® and peak knee extension moment, average knee extension moment, and total knee work was quantified using the laboratory instrumentation. Limb symmetry indices were quantified for each outcome measure. Multivariate backwards regressions were used to determine if loadsol® symmetry could predict knee kinetic symmetry. Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to determine the agreement and error between predicted and actual knee kinetic symmetry. Loadsol® impulse and peak impact force symmetry significantly predicted kinetic knee symmetry and explained 42-61% of its variance. There was good agreement (ICCs = 0.742-0.862) between predicted and actual knee kinetic symmetry, and the error in the predicted outcomes range from ±18 to ±43. These results support using the loadsol® to screen for kinetic symmetries during landing in athletes following ACL reconstruction.