The Role of Incorporating Biomechanical Devis (Apos) On Lower Limb Biomechanics Recreational Athletes with a High Risk for Second ACL after Primary ACL Reconstruction

Abstract

Introduction: Injury to the ACL is considered one of the most debilitating knee injuries which could occur in any young athlete. Patients who previously sustained non-contact ACL injury and had ACL reconstruction (ACLR) showed higher risk of sustaining a second ACL injury compared with individuals who did not sustain primary ACL injury. Persistent poor neuromuscular control reflecting on high-risk movement patterns at the contralateral lower limb, has been proposed as modified risk factors, which may exist even post ACLR. The long-term benefits of an effective rehabilitation program which focus on improving neuromuscular control may also be realised, both by the full restoration of functional performance and by the improved of the lower limb reflecting on better ability of post ACLR individuals to participate in lifetime activity with lower chances of sustaining 2nd ACL injury. Objective: Introduction of perturbation training with lower limb alignment re-adjustment by using (APOS). Methods: Participants: Five physical active healthy participants. All had had ACLR and completed their rehabilitation program and been returned to participate in sporting activities. All participants showed plane projection angle (FPPA) while performing Single Leg Squat exceed 8°. Interventions: The participants were instructed to use APOS during walking while performing their daily activities for period of minimum of 60 minutes on a daily basis for six weeks. Main Outcome Measurements: Centre of Pressure (COP) measures for Postural stability during Single leg stance (SLs) and KOOS questionnaire. Results: COP measures during SLs task showed significant improvement, and significant improvement in KOOS quality of life (QOL) subscales. Conclusion: poor postural stability has been considered a main mechanism for sustaining a 2nd ACL injury in patients who had ACLR surgery. The finding of this study is the first to show the promising concept of utilising foot-worn biomechanical interventions may be a different method for mitigating risks of a 2nd ACL injury.