Benoit Attalin, Telma Sagnard, Eric Laboute, Nicolas Forestier, Olivier Rémy-Néris, Brice Picot
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It has been hypothesized that athletes with ACLR exhibit impaired proprioceptive reweighting and poor postural control.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Fifty-two ACLR and 23 control elite athletes (50 males and 25 females, mean age 24.7 years) were included. Proprioceptive reweighting was determined using the evolution of proprioceptive weighting (eRPW), calculated from the center of pressure (CoP) displacements generated by tendon vibration during bilateral standing tasks on firm and foam surfaces. An eRPW <95% classified individuals as flexible (i.e., able to reweight proprioceptive signals from the ankle to the lumbar region), whereas an eRPW >105% classified individuals as rigid (i.e., maintaining an ankle dominant strategy). CoP velocity (vCoP) and CoP ellipse area (EA) were used to characterize postural control. Independent sample t-test and a Chi-squared test were used to compare eRPW, vCoP, EA, and the proportion of flexible and rigid athletes between groups.</p><p><strong>Results: </strong>The eRPW was higher in the ACLR group (100.9±58.8 vs. 68.6±26.6%; p=0.031; Rank biserial correlation=0.314; medium), with a greater proportion of rigid athletes than in the control group (38.5 vs. 4.4%; p=0.010), reflecting lower proprioceptive reweighting. The ACLR group had greater EA on foam surface (8.0±4.6 vs. 6.3±4.4cm²; p=0.019), revealing poorer postural control.</p><p><strong>Conclusion: </strong>Elite athletes with ACLR showed impaired proprioceptive reweighting and poor postural control on an unstable surface. This reflects an inability to adapt proprioceptive weighting when balance conditions are changing and suboptimal postural strategies.</p><p><strong>Level of evidence: </strong>3b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 11","pages":"1314-1323"},"PeriodicalIF":1.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534172/pdf/","citationCount":"0","resultStr":"{\"title\":\"Proprioceptive Reweighting and Postural Control are Impaired Among Elite Athletes Following Anterior Cruciate Ligament Reconstruction.\",\"authors\":\"Benoit Attalin, Telma Sagnard, Eric Laboute, Nicolas Forestier, Olivier Rémy-Néris, Brice Picot\",\"doi\":\"10.26603/001c.124802\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>After anterior cruciate ligament reconstruction (ACLR), the risk of recurrence can reach 20%, partially due to poor postural control and impaired sensory processing. Lack of flexibility in proprioceptive postural strategy has recently been shown to be a potential risk factor for ACL injury.</p><p><strong>Hypothesis/purpose: </strong>This study aimed to compare proprioceptive reweighting and postural control between ACLR and controls elite athletes. It has been hypothesized that athletes with ACLR exhibit impaired proprioceptive reweighting and poor postural control.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Fifty-two ACLR and 23 control elite athletes (50 males and 25 females, mean age 24.7 years) were included. Proprioceptive reweighting was determined using the evolution of proprioceptive weighting (eRPW), calculated from the center of pressure (CoP) displacements generated by tendon vibration during bilateral standing tasks on firm and foam surfaces. An eRPW <95% classified individuals as flexible (i.e., able to reweight proprioceptive signals from the ankle to the lumbar region), whereas an eRPW >105% classified individuals as rigid (i.e., maintaining an ankle dominant strategy). CoP velocity (vCoP) and CoP ellipse area (EA) were used to characterize postural control. Independent sample t-test and a Chi-squared test were used to compare eRPW, vCoP, EA, and the proportion of flexible and rigid athletes between groups.</p><p><strong>Results: </strong>The eRPW was higher in the ACLR group (100.9±58.8 vs. 68.6±26.6%; p=0.031; Rank biserial correlation=0.314; medium), with a greater proportion of rigid athletes than in the control group (38.5 vs. 4.4%; p=0.010), reflecting lower proprioceptive reweighting. The ACLR group had greater EA on foam surface (8.0±4.6 vs. 6.3±4.4cm²; p=0.019), revealing poorer postural control.</p><p><strong>Conclusion: </strong>Elite athletes with ACLR showed impaired proprioceptive reweighting and poor postural control on an unstable surface. 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引用次数: 0
摘要
背景：前交叉韧带重建术（ACLR）后，复发风险可达 20%，部分原因是姿势控制不佳和感觉处理受损。最近的研究表明，本体感觉姿势策略缺乏灵活性是前交叉韧带损伤的一个潜在风险因素。假设/目的：本研究旨在比较前交叉韧带重建精英运动员和对照组精英运动员的本体感觉再权重和姿势控制。据推测，患有前交叉韧带损伤的运动员本体感觉复重能力受损，姿势控制能力较差：研究设计：横断面研究：纳入 52 名前交叉韧带损伤运动员和 23 名对照组精英运动员（50 名男性和 25 名女性，平均年龄 24.7 岁）。使用本体感觉权重进化（ERPW）确定本体感觉再权重，ERPW 是根据在坚硬和泡沫表面上进行双侧站立任务时肌腱振动产生的压力中心（CoP）位移计算得出的。当ERPW达到105%时，个体被归类为僵直型（即保持踝关节主导策略）。CoP速度（vCoP）和CoP椭圆面积（EA）用于描述姿势控制。独立样本 t 检验和卡方检验用于比较各组之间的 eRPW、vCoP、EA 以及柔性和刚性运动员的比例：结果：前交叉韧带重建组的ERPW更高（100.9±58.8 vs. 68.6±26.6%；P=0.031；Rank biserial correlation=0.314；中等），僵硬运动员的比例高于对照组（38.5 vs. 4.4%；P=0.010），反映了本体感觉复重较低。前交叉韧带损伤组在泡沫表面的EA更大（8.0±4.6 vs. 6.3±4.4cm²；p=0.019），表明姿势控制能力更差：结论：患有前交叉韧带损伤的精英运动员在不稳定的表面上表现出本体感觉复重受损，姿势控制能力较差。这反映出当平衡条件发生变化时，本体感觉配重无法适应，以及姿势策略不理想：3b.
Proprioceptive Reweighting and Postural Control are Impaired Among Elite Athletes Following Anterior Cruciate Ligament Reconstruction.
Background: After anterior cruciate ligament reconstruction (ACLR), the risk of recurrence can reach 20%, partially due to poor postural control and impaired sensory processing. Lack of flexibility in proprioceptive postural strategy has recently been shown to be a potential risk factor for ACL injury.
Hypothesis/purpose: This study aimed to compare proprioceptive reweighting and postural control between ACLR and controls elite athletes. It has been hypothesized that athletes with ACLR exhibit impaired proprioceptive reweighting and poor postural control.
Study design: Cross-sectional study.
Methods: Fifty-two ACLR and 23 control elite athletes (50 males and 25 females, mean age 24.7 years) were included. Proprioceptive reweighting was determined using the evolution of proprioceptive weighting (eRPW), calculated from the center of pressure (CoP) displacements generated by tendon vibration during bilateral standing tasks on firm and foam surfaces. An eRPW <95% classified individuals as flexible (i.e., able to reweight proprioceptive signals from the ankle to the lumbar region), whereas an eRPW >105% classified individuals as rigid (i.e., maintaining an ankle dominant strategy). CoP velocity (vCoP) and CoP ellipse area (EA) were used to characterize postural control. Independent sample t-test and a Chi-squared test were used to compare eRPW, vCoP, EA, and the proportion of flexible and rigid athletes between groups.
Results: The eRPW was higher in the ACLR group (100.9±58.8 vs. 68.6±26.6%; p=0.031; Rank biserial correlation=0.314; medium), with a greater proportion of rigid athletes than in the control group (38.5 vs. 4.4%; p=0.010), reflecting lower proprioceptive reweighting. The ACLR group had greater EA on foam surface (8.0±4.6 vs. 6.3±4.4cm²; p=0.019), revealing poorer postural control.
Conclusion: Elite athletes with ACLR showed impaired proprioceptive reweighting and poor postural control on an unstable surface. This reflects an inability to adapt proprioceptive weighting when balance conditions are changing and suboptimal postural strategies.
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