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. 2013 Sep 27;48(4):293-299.
doi: 10.1016/j.rboe.2012.07.008. eCollection 2013 Jul-Aug.

Motor coordination during gait after anterior cruciate ligament injury: a systematic review of the literature

Gustavo Leporace  1 , Leonardo Metsavaht  2 , Liszt Palmeira de Oliveira  3 , Jurandir Nadal  4 , Luiz Alberto Batista  5
Affiliations

Motor coordination during gait after anterior cruciate ligament injury: a systematic review of the literature

Gustavo Leporace et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

To investigate the state of art about motor coordination during gait in patients with anterior cruciate ligament (ACL) injury. Searches were carried out, limited from 1980 to 2010, in various databases with keywords related to motor coordination, gait and ACL injury. From the analysis of titles and applying the inclusion/exclusion criteria 24 studies were initially selected and, after reading the abstract, eight studies remained in the final analysis. ACL deficient patients tend to have a more rigid and less variable gait, while injured patients with ACL reconstruction have less rigid and more variable gait with respect to healthy individuals. The overall results suggest the existence of differences in motor coordination between the segments with intact and those with injured knee, regardless of ligament reconstruction. ACL injured patients present aspects related to the impairment of the capability to adapt the gait pattern to different environmental conditions, possibly leading to premature knee degeneration. However, the techniques used for biomechanical gait data processing are limited with respect to obtaining information that leads to the development of intervention strategies aimed at the rehabilitation of that injury, since it is not possible to identify the location within the gait cycle where the differences could be explained.

Investigar o estado da arte acerca da coordenação motora durante a marcha em pacientes com lesão no ligamento cruzado anterior (LCA). Foram realizadas pesquisas, delimitadas entre 1980 e 2010, em diversas bases de artigos com palavras-chave relacionadas à coordenação motora, marcha e lesão no LCA. A partir da análise de títulos e aplicação dos critérios de inclusão/exclusão, 24 estudos foram selecionados inicialmente e, após a leitura do resumo, oito permaneceram na análise final. Os resultados indicam que pacientes com deficiência no LCA tendem a apresentar uma marcha menos variável, enquanto pacientes com reconstrução do LCA têm uma marcha mais variável, em relação a sujeitos hígidos. Os resultados sugerem a existência de diferenças na coordenação motora entre os segmentos entre sujeitos com e sem lesão no LCA, independentemente da reconstrução ligamentar. Pacientes com lesão no LCA apresentam aspectos relacionados ao comprometimento de adaptar seus padrões de marcha a diferentes condições externas, o que pode levar à degeneração precoce. No entanto, as técnicas usadas pelos estudos para o processamento dos dados biomecânicos foram limitadas no que diz respeito à obtenção de informações que possibilitem o desenvolvimento de estratégias de intervenção voltadas para a reabilitação da lesão. Isso se deve ao fato de as técnicas atuais de estudo da coordenação motora, apesar de possibilitar a identificação de alterações no padrão de marcha saudável, não serem capazes de identificar as principais articulações e fases do ciclo da marcha alteradas.

Keywords: Anterior cruciate ligament/injury Biomechanics; Gait; motor skills.

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Figures

Figure 1
Figure 1
Flow diagram explaining the study selection process in the systematic review. The dashed arrows represent the possible paths in the event of discrepancy between the first two examiners.
See this image and copyright information in PMC

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References

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Further reading

    1. Dingwell J.B., Cavanagh P.R. Increased variability of continuous overground walking in neuropathic patients is only indirectly related to sensory loss. Gait Posture. 2001;14(1):1–10. - PubMed

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