Background

A tailored postoperative physiotherapy program after anterior cruciate ligament (ACL) reconstruction is necessary for an early return to sport as well as to minimise the occurrence of long-term complications. However, there still exists no agreement of the benefit of supervised physiotherapy versus a hometraining program, Gait plays a major role in rehabilitation process but as 3D gait analysis is expensive, affordable and simple applicable devices are needed for clinical practice. Wearable systems like IMUs (Inertial Measurement Unit) are already used for clinical investigation, but there is still a lack of appropriate methods and scores for gait assessment, concerning rehabilitation after ACL-reconstruction. 

Goal 

The main objective is a gait-related evaluation of the early rehabilitation progress after the ACL reconstruction using simplified gait analysis. A new ACL-rehabilitation score will be developed, including clinical parameters and standard gait parameters (kinematics, kinetics, spatiotemporal characteristics) as well as more sophisticated gait parameters like symmetry, variability, complexity or local stability. Statistical analysis is performed to determine the influence of the rehabilitation programs and the adequacy of the score determined from IMU data compared to 3D gait analysis data. 

Complementary expertise 

The relevant expertise to approach this topic is available in Lower Austria:  The Karl Landsteiner University Krems has expertise in biomechanical issues and data analysis, the university hospital Krems is experienced in clinical rehabilitation and therapy and St. Pölten UAS provides knowledge in gait analysis issues and - with a new 3D gait analysis system - also infrastructure. Further, St. Pölten UAS has growing expertise in conducting clinical trials with the focus on rehabilitation and physiotherapy.

Results 

The results not only give information about the impact of physiotherapeutic supervision on the early normalisation of gait and on the question if home-based programs can confidently be recommended for specific patients. It also provides a clinically applicable method for gait assessment which can be integrated in the routine follow-up procedure after ACL-reconstruction and used to answer related scientific questions. Furthermore, the method can lay the basis for developing similar scores in different fields of rehabilitation or therapy assessment.