Neuromuscular activity of the lower-extremities during running, landing and changing-of-direction movements in individuals with anterior cruciate ligament reconstruction: a review of electromyographic studies

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dc.contributor.authorGeorgoulis, Jim D.
dc.contributor.authorMelissaridou, Dimitra
dc.contributor.authorPatras, Kostas
dc.contributor.authorMegaloikonomos, Panayiotis D.
dc.contributor.authorTrikoupis, Ioannis
dc.contributor.authorSavvidou, Olga D.
dc.contributor.authorPapagelopoulos, Panayiotis J.
dc.date.accessioned2023-05-01T15:04:30Z
dc.date.available2023-05-01T15:04:30Z
dc.date.issued2023-04-14
dc.date.updated2023-05-01T03:11:22Z
dc.description.abstractAbstract Purpose Running, jumping/landing and cutting/change of direction (CoD) are critical components of return to sport (RTS) following anterior cruciate ligament reconstruction (ACLR), however the electromyographic (EMG) activity patterns of the operated leg during the execution of these tasks are not clear. Methods A systematic review was conducted to retrieve EMG studies during running, jumping/landing and cutting/(CoD) in ACLR patients. MEDLINE, PubMed, SPORTDiscus and Web of Science databases were searched from 2000 to May, 2022 using a combination of keywords and their variations: “anterior cruciate ligament reconstruction” OR “ACLR”, “electromyography” OR “EMG”, “running”, “jumping” OR “landing”, “cutting” OR “change-of-direction” OR “CoD”. The search identified studies comparing EMG data during running, landing and cutting/(CoD) between the involved limb and contralateral or control limbs. Risk of bias was assessed and quantitative analyses using effect sizes were performed. Results Thirty two studies met the inclusion criteria. Seventy five percent (24/32) of the studies reported altered EMG activity pattern of the ACLR leg during running, jumping/landing and cutting/(CoD) when compared with either the healthy control leg or the contra-lateral leg. Twelve studies showed decreased, delayed or earlier onset and delayed peak in quadriceps EMG activity with small to large effect sizes and 9 studies showed increased, delayed or earlier onset and delayed peak in hamstrings EMG activity with small to large effect sizes. Four studies showed a “hamstrings-dominant” strategy i.e. decreased quadriceps coupled with increased hamstrings EMG activity in both running and jumping/landing irrespective of graft type. One study reported that on the grounds of decreased quadriceps activity, lower hamstrings EMG activity was predictive of ipsilateral re-injury in ACLR patients. Conclusion This systematic review of Level III evidence showed that the ACLR leg displays decreased quadriceps or increased hamstrings EMG activity or both despite RTS. Simultaneous decreased quadriceps and increased hamstrings EMG activity was shown for both running and jumping/landing. From a clinical perspective this “hamstrings dominant” strategy can serve as a protective mechanism against graft re-injury. Level of evidence III.en_US
dc.identifier.citationJournal of Experimental Orthopaedics. 2023 Apr 14;10(1):43
dc.identifier.citationJournal of Experimental Orthopaedics. 2023 Apr 14;10(1):43
dc.identifier.urihttps://doi.org/10.1186/s40634-023-00603-1
dc.identifier.urihttp://hdl.handle.net/1993/37306
dc.language.isoengen_US
dc.language.rfc3066en
dc.publisherBioMed Central (BMC)en_US
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.titleNeuromuscular activity of the lower-extremities during running, landing and changing-of-direction movements in individuals with anterior cruciate ligament reconstruction: a review of electromyographic studiesen_US
dc.typejournal articleen_US
local.author.affiliationFaculty of Kinesiology and Recreation Managementen_US
oaire.citation.issue1en_US
oaire.citation.startPage43en_US
oaire.citation.titleJournal of Experimental Orthopaedicsen_US
oaire.citation.volume10en_US
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