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1- Department of Sport Biomechanics, Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
2- Department of Internal Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran, Iran
2- Department of Internal Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran, Iran
Abstract: (19 Views)
Purpose: This study investigated the interactive effects of different foot orthoses (FOs) and post-operative duration on the time to peak (TTP) of ground reaction force (GRF) components and center of pressure (COP) excursions in individuals with anterior cruciate ligament reconstruction (ACLR) and pronated feet (PF).
Methods: In a single-blinded (assessor-blinded), controlled study, 45 right-limb dominant males with ACLR and PF were stratified into three groups based on post-operative time: 6, 12, and 18-month. A control group of 15 healthy individuals with neutral feet was also included. Participants ran at 3.2 m/s under four-foot conditions: control shoe, placebo orthotic, arch-support orthotic, and double-density orthotic. GRF and COP data were collected using a force platform. A 4×4 mixed-model ANOVA was used to analyze main and interaction effects on TTP and COP variables.
Results: Significant main effects of group were found for all TTP variables and COP excursions (p < 0.05), indicating distinct loading patterns across recovery stages. The 6-month ACLR group demonstrated a significantly lower TTP for lateral force and greater TTP for medial, anterior, posterior, and active vertical peaks compared to healthy controls. Significant main effects of FOs were observed for TTP Peak medial, posterior, anterior, and COP excursions (p < 0.05). Crucially, significant group × FOs interactions were detected for TTP Peak medial, anterior, active vertical peak, and COP excursions (p < 0.05).
Conclusion: The efficacy of foot orthoses following ACLR is recovery-phase dependent. Arch-support orthoses are particularly beneficial for modifying sagittal plane loading patterns during early rehabilitation at 6-month, whereas double-density orthoses provide superior frontal plane control during advanced stages at 12-month. These findings underscore the importance of phase-specific orthotic prescription following ACL reconstruction and highlight the need for individualized biomechanical assessment to optimize rehabilitation outcomes, improve dynamic loading control during running, and potentially reduce the risk of graft overload and long-term joint degeneration.
Methods: In a single-blinded (assessor-blinded), controlled study, 45 right-limb dominant males with ACLR and PF were stratified into three groups based on post-operative time: 6, 12, and 18-month. A control group of 15 healthy individuals with neutral feet was also included. Participants ran at 3.2 m/s under four-foot conditions: control shoe, placebo orthotic, arch-support orthotic, and double-density orthotic. GRF and COP data were collected using a force platform. A 4×4 mixed-model ANOVA was used to analyze main and interaction effects on TTP and COP variables.
Results: Significant main effects of group were found for all TTP variables and COP excursions (p < 0.05), indicating distinct loading patterns across recovery stages. The 6-month ACLR group demonstrated a significantly lower TTP for lateral force and greater TTP for medial, anterior, posterior, and active vertical peaks compared to healthy controls. Significant main effects of FOs were observed for TTP Peak medial, posterior, anterior, and COP excursions (p < 0.05). Crucially, significant group × FOs interactions were detected for TTP Peak medial, anterior, active vertical peak, and COP excursions (p < 0.05).
Conclusion: The efficacy of foot orthoses following ACLR is recovery-phase dependent. Arch-support orthoses are particularly beneficial for modifying sagittal plane loading patterns during early rehabilitation at 6-month, whereas double-density orthoses provide superior frontal plane control during advanced stages at 12-month. These findings underscore the importance of phase-specific orthotic prescription following ACL reconstruction and highlight the need for individualized biomechanical assessment to optimize rehabilitation outcomes, improve dynamic loading control during running, and potentially reduce the risk of graft overload and long-term joint degeneration.
Keywords: Anterior Cruciate Ligament Reconstruction, Time to Peak, Ground Reaction Force, Center of Pressure, Running, Foot Orthoses
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