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Biofeedback Impact on Limb Stiffness and Joint Power in Patients With ACL Reconstruction-A Secondary Analysis
Vaibhavi Rathod1, Bryana N Vasquez1, Michael A Teater1
1Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA.
Summary
Biofeedback did not significantly improve limb stiffness or eccentric knee joint power symmetry after anterior cruciate ligament reconstruction. Landing biomechanics showed persistent deficits between surgical and non-surgical limbs post-intervention.
Area of Science:
- Biomechanics
- Rehabilitation Science
- Sports Medicine
Background:
- Anterior cruciate ligament reconstruction (ACLR) often results in persistent deficits in limb symmetry and altered landing biomechanics.
- Restoring symmetrical function is crucial for optimal recovery and reducing re-injury risk after ACLR.
- Biofeedback interventions are explored to enhance neuromuscular control and improve biomechanical outcomes.
Purpose of the Study:
- To investigate the efficacy of a 12-week biofeedback intervention on limb stiffness and eccentric knee joint power (ECCKP) symmetry in individuals post-ACLR.
- To assess the impact of biofeedback on related landing biomechanics, including ground reaction forces and limb length changes.
- To evaluate outcomes at baseline, post-intervention, and during a retention period.
Main Methods:
- Thirty-three participants (14 biofeedback, 19 control) underwent a 12-week intervention protocol.
- Linear mixed-effects models were used to analyze group and time-point effects on ECCKP and limb stiffness normalized symmetry indices (NSI).
- Analysis also included limb-specific (surgical vs. non-surgical) biomechanics: limb stiffness, peak relative ground reaction force (rGRF), limb length change, and time to peak rGRF.
Main Results:
- No significant group × time-point interactions were observed for ECCKP NSI or limb stiffness NSI, indicating biofeedback did not improve symmetry.
- The non-surgical limb consistently demonstrated greater limb stiffness, higher peak rGRF, and longer time to peak rGRF compared to the surgical limb.
- No significant effects were found for change in limb length; peak rGRF was also lower post-intervention compared to baseline.
Conclusions:
- The biofeedback intervention did not significantly enhance limb stiffness or ECCKP symmetry in the post-ACLR population.
- Persistent symmetry deficits in landing biomechanics between surgical and non-surgical limbs were evident.
- The study may have been underpowered; larger, well-powered trials are recommended to confirm biofeedback's role in dynamic task symmetry post-ACLR.
