The influence of altered lower-limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstruction
IntroductionDeficits in lower-limb muscle strength and altered gait mechanics are common after anterior cruciate ligament reconstruction (ACL). While isokinetic strength testing is widely accepted in return-to-sport assessment, the role of plantar pressure analysis in detecting compensatory gait str...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-08-01
|
| Series: | Frontiers in Sports and Active Living |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fspor.2025.1569129/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849233402118537216 |
|---|---|
| author | Karolína Matov Michal Bozděch Marta Gimunová Martin Komzák Marek Dostál Miloslav Maršálek Tomáš Vespalec Milan Mojžíš Tomáš Vodička |
| author_facet | Karolína Matov Michal Bozděch Marta Gimunová Martin Komzák Marek Dostál Miloslav Maršálek Tomáš Vespalec Milan Mojžíš Tomáš Vodička |
| author_sort | Karolína Matov |
| collection | DOAJ |
| description | IntroductionDeficits in lower-limb muscle strength and altered gait mechanics are common after anterior cruciate ligament reconstruction (ACL). While isokinetic strength testing is widely accepted in return-to-sport assessment, the role of plantar pressure analysis in detecting compensatory gait strategies remains underexplored.MethodsThis study included 10 male patients (30.27 ± 5.59 years; 178.37 ± 6.30 cm; 84.85 ± 10.74 kg) who underwent ACL reconstruction using bone–patellar tendon–bone autografts. Assessments were performed preoperatively and at 3 and 6 months postoperatively, evaluating isokinetic knee strength and plantar pressure distribution during barefoot level walking. Non-parametric Friedman tests with Kendall's W assessed temporal differences, followed by Conover post hoc tests with Bonferroni correction. Spearman's rank correlation examined associations between muscle strength and plantar pressure.ResultsSignificant deficits in extensor strength were found at both postoperative time points compared to preoperative levels (both p < .001), with improvement at six months vs. three (p < .001). Flexor strength showed a similar but less pronounced recovery (p = .005). Plantar pressure analysis revealed changes relative to baseline: reduced hindfoot contact area at six months (p = .035), decreased midfoot maximum force at three (p = .047) and six months (p = .026), and lower peak pressure under the fifth metatarsal head at six months (p = .035). No significant correlations emerged between muscle strength and plantar pressure parameters.DiscussionThese findings suggest plantar pressure analysis may complement return-to-sport evaluation by revealing hindfoot asymmetries persisting despite strength recovery. However, as dynamic plantar pressure parameters do not reflect quadriceps or hamstring status reliably, they cannot replace standard tests like isokinetic dynamometry. Combining plantar pressure metrics with conventional strength and functional assessments may better identify residual gait deficits and guide targeted rehabilitation to lower reinjury risk. |
| format | Article |
| id | doaj-art-6a0b7f771e414a7aaa4547c792fee921 |
| institution | Kabale University |
| issn | 2624-9367 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Sports and Active Living |
| spelling | doaj-art-6a0b7f771e414a7aaa4547c792fee9212025-08-20T05:32:58ZengFrontiers Media S.A.Frontiers in Sports and Active Living2624-93672025-08-01710.3389/fspor.2025.15691291569129The influence of altered lower-limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstructionKarolína Matov0Michal Bozděch1Marta Gimunová2Martin Komzák3Marek Dostál4Miloslav Maršálek5Tomáš Vespalec6Milan Mojžíš7Tomáš Vodička8Department of Physical Activities and Health Sciences, Masaryk University, Faculty of Sports Studies, Brno, CzechiaDepartment of Physical Education and Social Sciences, Masaryk University, Faculty of Sports Studies, Brno, CzechiaDepartment of Physical Activities and Health Sciences, Masaryk University, Faculty of Sports Studies, Brno, CzechiaDepartment of Physical Activities and Health Sciences, Masaryk University, Faculty of Sports Studies, Brno, CzechiaDepartment of Biophysics, Masaryk University, Faculty of Medicine, Brno, CzechiaOrthopedic Clinic, University Hospital Brno, Brno, CzechiaDepartment of Physical Activities and Health Sciences, Masaryk University, Faculty of Sports Studies, Brno, CzechiaDepartment of Physical Activities and Health Sciences, Masaryk University, Faculty of Sports Studies, Brno, CzechiaDepartment of Physical Activities and Health Sciences, Masaryk University, Faculty of Sports Studies, Brno, CzechiaIntroductionDeficits in lower-limb muscle strength and altered gait mechanics are common after anterior cruciate ligament reconstruction (ACL). While isokinetic strength testing is widely accepted in return-to-sport assessment, the role of plantar pressure analysis in detecting compensatory gait strategies remains underexplored.MethodsThis study included 10 male patients (30.27 ± 5.59 years; 178.37 ± 6.30 cm; 84.85 ± 10.74 kg) who underwent ACL reconstruction using bone–patellar tendon–bone autografts. Assessments were performed preoperatively and at 3 and 6 months postoperatively, evaluating isokinetic knee strength and plantar pressure distribution during barefoot level walking. Non-parametric Friedman tests with Kendall's W assessed temporal differences, followed by Conover post hoc tests with Bonferroni correction. Spearman's rank correlation examined associations between muscle strength and plantar pressure.ResultsSignificant deficits in extensor strength were found at both postoperative time points compared to preoperative levels (both p < .001), with improvement at six months vs. three (p < .001). Flexor strength showed a similar but less pronounced recovery (p = .005). Plantar pressure analysis revealed changes relative to baseline: reduced hindfoot contact area at six months (p = .035), decreased midfoot maximum force at three (p = .047) and six months (p = .026), and lower peak pressure under the fifth metatarsal head at six months (p = .035). No significant correlations emerged between muscle strength and plantar pressure parameters.DiscussionThese findings suggest plantar pressure analysis may complement return-to-sport evaluation by revealing hindfoot asymmetries persisting despite strength recovery. However, as dynamic plantar pressure parameters do not reflect quadriceps or hamstring status reliably, they cannot replace standard tests like isokinetic dynamometry. Combining plantar pressure metrics with conventional strength and functional assessments may better identify residual gait deficits and guide targeted rehabilitation to lower reinjury risk.https://www.frontiersin.org/articles/10.3389/fspor.2025.1569129/fullanterior cruciate ligament reconstructionplantar pressuremuscle strengthisokinetic dynamometryreturn-to-the-sport criteriaasymmetries |
| spellingShingle | Karolína Matov Michal Bozděch Marta Gimunová Martin Komzák Marek Dostál Miloslav Maršálek Tomáš Vespalec Milan Mojžíš Tomáš Vodička The influence of altered lower-limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstruction Frontiers in Sports and Active Living anterior cruciate ligament reconstruction plantar pressure muscle strength isokinetic dynamometry return-to-the-sport criteria asymmetries |
| title | The influence of altered lower-limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstruction |
| title_full | The influence of altered lower-limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstruction |
| title_fullStr | The influence of altered lower-limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstruction |
| title_full_unstemmed | The influence of altered lower-limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstruction |
| title_short | The influence of altered lower-limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstruction |
| title_sort | influence of altered lower limb muscle strength on dynamic plantar pressure distribution in participants who underwent anterior cruciate ligament reconstruction |
| topic | anterior cruciate ligament reconstruction plantar pressure muscle strength isokinetic dynamometry return-to-the-sport criteria asymmetries |
| url | https://www.frontiersin.org/articles/10.3389/fspor.2025.1569129/full |
| work_keys_str_mv | AT karolinamatov theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT michalbozdech theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT martagimunova theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT martinkomzak theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT marekdostal theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT miloslavmarsalek theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT tomasvespalec theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT milanmojzis theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT tomasvodicka theinfluenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT karolinamatov influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT michalbozdech influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT martagimunova influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT martinkomzak influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT marekdostal influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT miloslavmarsalek influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT tomasvespalec influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT milanmojzis influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction AT tomasvodicka influenceofalteredlowerlimbmusclestrengthondynamicplantarpressuredistributioninparticipantswhounderwentanteriorcruciateligamentreconstruction |