Identification of strength and spatiotemporal gait parameters associated with knee loading during gait in persons after anterior cruciate ligament reconstruction.

CONTEXT Altered knee moments are common during gait in patients following anterior cruciate ligament reconstruction (ACLR). Modifiable factors that influence knee moments and are feasible to record in clinical settings such as strength and spatiotemporal parameters (e.g. step length, step width) have not been identified in persons after ACLR. OBJECTIVE The objective was to identify strength and spatiotemporal gait parameters that can predict knee moments in persons after ACLR. DESIGN Cross-Sectional Study Setting: Laboratory Patients: Twenty-three participants with ACLR (14.4 ± 17.2 months post-ACLR) participated. MAIN OUTCOME MEASURES Peak knee flexion and adduction moments were measured while walking at self-selected speeds. Spatiotemporal gait parameters were recorded with a pressure walkway, and peak isokinetic knee extensor strength (60°/s) was recorded on a dynamometer. Pearson coefficients were used to examine the association of peak knee moments with strength and gait parameters. Variables correlated with peak knee flexion and adduction moments were entered into a stepwise regression model. RESULTS Step width and knee extensor strength were the strongest predictors of knee flexion moment accounting for 44% of data variance, whereas stance phase time and step width were the strongest predictors of knee adduction moment explaining 62% of data variance. CONCLUSIONS The spatiotemporal variables that were identified could be clinically feasible targets for biofeedback to improve gait after ACLR.