Individuals early after anterior cruciate ligament reconstruction show intact motor learning of step length via the split-belt treadmill

• Published in: Clinical biomechanics (Bristol) Vol. 115; p. 106256
• Main Authors: Arhos, Elanna K., Wood, Jonathan M., Silbernagel, Karin Grävare, Morton, Susanne M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2024
• Subjects: Adaptation, Physiological; Adult; Anterior cruciate ligament; Anterior Cruciate Ligament - physiopathology; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries - physiopathology; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - methods; Anterior Cruciate Ligament Reconstruction - rehabilitation; Biomechanical Phenomena; Exercise Test; Female; Gait; Gait - physiology; Humans; Learning; Male; Rehabilitation; Sensorimotor adaptation; Walking - physiology; Young Adult; Rehabilitation; Gait; Sensorimotor adaptation; Anterior cruciate ligament
• ISSN: 0268-0033; 1879-1271; 1879-1271
• DOI: 10.1016/j.clinbiomech.2024.106256

Rupturing the anterior cruciate ligament is an orthopedic injury that results in neuromuscular impairments affecting sensory input to the central nervous system. Traditional physical therapy after anterior cruciate ligament reconstruction aims to rehabilitate orthopedic impairments but fails to address asymmetric gait mechanics that are present post-operatively and are linked to the development of post-traumatic osteoarthritis. A first step towards developing gait interventions is understanding if individuals after anterior cruciate ligament reconstruction have the capacity to learn new walking mechanics. The split-belt treadmill offers a task-specific approach to examine neuromuscular adaptations in patients after injury. The potential for changing spatiotemporal gait mechanics via split-belt treadmill adaptation has not been tested early after anterior cruciate ligament reconstruction; nor has the ability to retain and transfer newly learned gait mechanics. Therefore, we used a split-belt treadmill paradigm to compare gait adaptation, retention, and transfer to overground walking between 15 individuals 3–9 months after anterior cruciate ligament reconstruction and 15 matched control individuals. Results suggested individuals after anterior cruciate ligament reconstruction were able to adapt and retain step length symmetry changes as well as controls. There was also evidence of partial transfer to overground walking, similar to controls. Despite disruption in afferent feedback from the joint, individuals early after anterior cruciate ligament reconstruction can learn a new gait pattern using sensorimotor adaptation, retain, and partially transfer the learned gait pattern. This may be a critical time to intervene with gait-specific interventions targeting post-operative gait asymmetries. •Individuals after anterior cruciate ligament reconstruction can learn new walking patterns.•They do not learn a new step length symmetry pattern differently than controls.•The newly learned step length symmetry pattern is retained over the short-term.•The newly learned step length symmetry pattern partially transfers to overground.