The effect of fatigue protocol on ankle and knee muscle co-contraction during walking in people with anterior cruciate ligament injury reconstruction with pronated foot

Sheikhalizadeh , Hamed; Jafarnezhadgero, AmirAli; Memarbashi , Abbas; Sajedi, Heidar; Enteshari Moghaddam, Afsaneh

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Volume 33, Issue 5 (11-2025)

Journal of Ilam University of Medical Sciences 2025, 33(5): 37-52

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The effect of fatigue protocol on ankle and knee muscle co-contraction during walking in people with anterior cruciate ligament injury reconstruction with pronated foot

Hamed Sheikhalizadeh¹

, AmirAli Jafarnezhadgero ^*²

, Abbas Memarbashi¹

, Heidar Sajedi³

, Afsaneh Enteshari Moghaddam⁴

1- Dept of Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
2- Dept of Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran , hamed.sheikhlizade@gmail.com
3- Dept of Exercise and Sports Sciences for Disabled People, International Science and Technology University, Ankara, Turkey
4- Dept of Internal Medicine, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran

Abstract: (33 Views)

Introduction: Anterior cruciate ligament rupture (ACL) is among the most common sports-related injuries. This study examined how an acute fatigue protocol alters ankle and knee-muscle co-contraction during gait in individuals with unilateral Anterior cruciate ligament reconstruction who also present with a pronated foot.
Materials & Methods: The research was a quasi-experimental and laboratory study. The subjects were 15 men with ACLR and pronated feet and 15 healthy men. Surface electromyography of selected lower-limb muscles was recorded while participants walked on a treadmill. After completing a standardised fatigue protocol, EMG was collected again during running. A two-way repeated-measures ANOVA (group × time) was performed in SPSS V 26 at p less than 0.05.
Results: A significant main effect of time was found for overall ankle co-contraction during the loading-response (P = 0.003, d = 0.329), mid-stance (P = 0.023, d = 0.212), and propulsion phases (P < 0.001, d = 0.865) of gait. A significant main effect of group was observed for overall knee co-contraction in the loading-response (P < 0.001, d = 0.377) and mid-stance phases (P = 0.044, d = 0.172). Group differences were also significant for directional knee co-contraction in mid-stance (P = 0.022, d = 0.215) and for directional ankle co-contraction in loading-response (P = 0.013, d = 0.251).
Conclusion: Individuals with ACLR and a pronated foot exhibit a lower co-contraction level at the knee and ankle compared with healthy controls, and fatigue further amplifies this reduction. Diminished co-contraction may compromise joint stability, alter gait mechanics, and increase injury risk in this population.

Keywords: Balance, Stability, Gait Pattern, Anterior Cruciate Ligament, Pronated Foot

Full-Text [PDF 1025 kb] (21 Downloads)

Type of Study: Research | Subject: anatomy
Received: 2025/07/7 | Accepted: 2025/09/3 | Published: 2025/11/26

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Sheikhalizadeh H, Jafarnezhadgero A, Memarbashi A, Sajedi H, Enteshari Moghaddam A. The effect of fatigue protocol on ankle and knee muscle co-contraction during walking in people with anterior cruciate ligament injury reconstruction with pronated foot. J. Ilam Uni. Med. Sci. 2025; 33 (5) :37-52
URL: http://sjimu.medilam.ac.ir/article-1-8671-en.html

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