Fatigue’s Lack of Effect on Thigh-Muscle Activity in Anterior Cruciate Ligament–Reconstructed Patients During a Dynamic-Landing Task

Abstract

Context:As individuals returning to activity after anterior cruciate ligament reconstruction (ACLr) likely experience fatigue, understanding how fatigue affects knee-muscle activation patterns during sport-like maneuvers is of clinical importance. Fatigue has been suggested to impair neuromuscular control strategies. As a result, fatigue may place ACLr patients at increased risk of developing posttraumatic osteoarthritis (OA).Objective:To determine the effects of fatigue on knee-muscle activity post-ACLr.Design:Case control.Setting:University laboratory.Participants:12 individuals 7–10 mo post-ACLr (7 male, 5 female; age 22.1 ± 4.7 y; 1.8 ± 0.1 m; mass 77.7 ± 11.9 kg) and 13 controls (4 male, 9 female; age 22.9 ± 4.3 y; 1.7 ± 0.1 m; mass 66.9 ± 9.8 kg).Interventions:Fatigue was induced via repetitive sets of double-leg squats (n = 8), which were interspersed with sets of single-leg landings (n = 3), until squats were no longer possible.Main Outcome Measures:2 × 2 repeated-measures ANOVA was used to detect the main effects of group (ACLr, control) and fatigue state (prefatigue, postfatigue) on quadriceps:hamstring cocontraction index (Q:H CCI).Results:All subjects demonstrated higher Q:H CCI at prefatigue compared with postfatigue (F1,23 = 66.949, P ≤ .001). Q:H CCI did not differ between groups (F1,23 = 0.599, P = .447).Conclusions:The results indicate that regardless of fatigue state, ACLr individuals are capable of restoring muscle-activation patterns similar to those in healthy subjects. As a result, excessive muscle cocontraction, which has been hypothesized as a potential mechanism of posttraumatic OA, may not contribute to joint degeneration after ACLr.