Abstract

Background. Anterior cruciate ligament rupture is a common and severe sports injury among athletes, directly affecting knee joint stability and threatening their sports careers. Gait, as a high-frequency movement pattern, is closely related to central nervous system control, and lower limb lesions often lead to abnormal gait. This study aims to analyze the correlation between the symmetry of lower limb muscle control in the gait of patients after Anterior cruciate ligament reconstruction and the risk of returning to sports based on the Knee Santy Athletic Return to Sport assessment, providing scientific guidance for rehabilitation training and helping patients restore their sports ability and reduce the risk of injury when returning to sports.

Methods. The study included 33 patients who had undergone anterior cruciate ligament reconstruction as subjects (athletes at the national second level and above). Six months after unilateral anterior cruciate ligament reconstruction surgery, they underwent tandem gait and stable gait tests, and data from six complete gait cycles were collected and averaged. The Knee Santy Athletic Return to Sport test was also conducted. The measured indicators included step length, walking speed, peak amplitude of muscle activation, and the time of peak amplitude of muscle activation. Symmetry indices were calculated, and correlation analyses were performed.

Results. In the stable gait test, the symmetry index of rectus femoris muscle activation peak amplitude was significantly positively correlated with the knee motion return test score (r = 0.420, P = 0.015). The symmetry index of vastus lateralis muscle activation peak amplitude was also significantly positively correlated with the knee motion return test score (r = 0.435, P = 0.011). The remaining test results showed no correlation with the Knee Santy Athletic Return to Sport test score (P > 0.05).

Discussion. The symmetry of neuromuscular control of the quadriceps femoris (especially the rectus femoris and vastus lateralis) in patients after Anterior cruciate ligament reconstruction is closely related to the risk of returning to sports. This finding suggests that the strength and symmetry training of the rectus femoris and vastus lateralis should be emphasized in rehabilitation training. Meanwhile, the symmetry of the peak amplitude of activation of the rectus femoris and vastus lateralis during stable gait can be used as one of the reference indicators for assessing the risk of returning to sports, providing a scientific basis for rehabilitation training.