Preliminary analysis of lower extremity loading in ACL reconstructed individuals following a gait retraining intervention using real-time gait biofeedback (2023)
Undergraduate: Olivia Sallis
Faculty Advisor: Brian Pietrosimone
Department: Exercise and Sport Science
Background: Following anterior cruciate ligament reconstruction (ACLR), individuals often exhibit aberrant gait mechanics, placing them at increased risk of post-traumatic osteoarthritis (PTOA). Biofeedback has been successfully used acutely to improve altered gait mechanics post-ACLR and may be a useful therapeutic tool for gait retraining to mitigate biomechanics linked to PTOA. Purpose: Determine the effect of a real-time gait biofeedback (RTGBF) intervention on the retention of normalized gait biomechanics in ACLR individuals compared to a control intervention (SHAM). Methods: 19 individuals with unilateral ACLR participated in this randomized crossover study and were block randomized into the RTGBF or SHAM groups (RTGBF: n=9, 89% female, age=22±5 years, BMI=24.6±3.62 kg/m^2, months post-ACLR= 29±21; SHAM: n=10, 80% female, age=22±4 years, BMI=24.3±5.09 kg/m^2, months post-ACLR= 17±21). Over 6 weeks, participants completed 18 training sessions of either the RTGBF or SHAM interventions. The RTGBF was designed to cue an increase in peak vertical ground reaction force (vGRF) while the SHAM was designed to not change gait mechanics. vGRF was collected at baseline (B), and at 6-week (6W) and 8-week (8W) post-intervention. Hedge’s g effect sizes and 95% confidence interval were used to examine the change from B to 6W and 8W within groups and examine the effectiveness of the intervention by comparing the change in vGRF from B and 6W (B-6W) and B and 8W (B-8W) between groups. Results: RTGBF led to an increase in vGRF (6W: 0.01±0.03, g=0.51; 8W: 0.04±0.05, g=1.28) compared to the SHAM group (6W: -0.002±0.02, g=0.02, 8W: 0.004±0.03, g=0.08). A medium effect was present between groups from B-6W (g=0.49), and a large effect was present from B-8W (g=0.94), suggesting the RTGBF effectively increased vGRF compared to the SHAM, however, these results must be interpreted with caution as 95% confidence intervals crossed 0. Conclusions: These preliminary results indicate RTGBF gait retraining may improve vGRF profiles in ACLR individuals and may be retained 2 weeks post-training.
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