Evidence map›Paper›PMID 42212173›Full record

ArticleFrontiers in bioengineering and biotechnology2026

Gait asymmetry as a determinant of functional recovery and return to sport after ACL reconstruction: a cross-sectional biomechanical analysis.

Ali Ibrahim Alhefzi, Ravi Shankar Reddy, Fareed F Alfaya, Shaker Hassan S Alshehri, Debjani Mukherjee, Batool A Alkhamis, Irshad Ahmad, Saleh Kardm, Ghada Mohamed Koura, Zuhair Al Salim and 5 more

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Article in Frontiers in bioengineering and biotechnology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Ali Ibrahim AlhefziDepartment of Orthopedic Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Ravi Shankar ReddyProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Fareed F AlfayaDepartment of Orthopedic Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Shaker Hassan S AlshehriDepartment of Orthopedic Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Debjani MukherjeeProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Batool A AlkhamisProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Irshad AhmadProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Saleh KardmDepartment of Surgery, College of Medicine, Najran University, Najran, Saudi Arabia.
Ghada Mohamed KouraProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Zuhair Al SalimDepartment of Sport Science and Physical Activity, University of Hafr Al Batin, Hafar Al-Batin, Saudi Arabia.
Ajay Prashad GautamProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Faisal M AlyazediDepartment of Physical Therapy, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia.
Sara Mohamed SamirDepartment of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
Ahmed Mohamed Fathi ElshiwiDepartment of Physical Therapy, Saudi German Hospital, Aseer, Saudi Arabia.
Ahmed M El MelhatDepartment of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Gait asymmetry and impaired functional performance are common after anterior cruciate ligament (ACL) reconstruction and may influence return-to-sport (RTS) outcomes. Despite advancements in rehabilitation, a substantial proportion of individuals fail to regain pre-injury activity levels, often due to unresolved biomechanical deficits. Quantifying gait asymmetry and its relationship with functional capacity may provide insight into factors that differentiate those who successfully return to sport from those who do not. Methods: Eighty-six participants (43 RTS, 43 non-RTS) between 6 and 24 months post-ACL reconstruction completed 3D gait analysis and a standardized battery of single-leg hop tests. Gait asymmetry indices included kinetic and kinematic variables, while functional performance was assessed using hop distances, timed hops, and limb symmetry indices (LSIs). Group comparisons were analyzed using independent Results: The RTS group demonstrated significantly lower asymmetry across all gait variables, including vertical ground reaction force asymmetry expressed as an asymmetry index percentage derived from body-weight-normalized force values (8.45% ± 3.21% vs. 12.34% ± 4.02%, p = 0.001) and peak knee flexion angle asymmetry (degrees; 3.12 ± 1.10° vs. 5.67 ± 1.45°, p < 0.001). They also performed better on all hop tests, including single-leg hop distance (centimeters; 162.34 ± 12.45 vs. 148.76 ± 14.33 cm, p < 0.001) and Limb Symmetry Index for the 6-m timed hop (percentage ratio of involved-to-uninvolved limb performance; 96.45% ± 2.85% vs. 88.34% ± 3.65%, p < 0.001). Gait asymmetry metrics showed moderate-to-strong correlations with hop performance (r = -0.58 to 0.44). Regression analysis identified peak knee flexion angle asymmetry (B = -2.45, β = -0.41, p < 0.001) and knee extensor moment asymmetry (B = -8.12, β = -0.39, p = 0.004) as significant predictors. Conclusion: Gait asymmetry differentiates individuals based on RTS status and significantly predicts functional performance after ACL reconstruction. These findings support the clinical integration of gait analysis to guide rehabilitation and RTS decisions.

Indexed as

anterior cruciate ligament reconstructionbiomechanical Phenomenagait analysisrehabilitationreturn to sport

Identifiers

PMID42212173
PMCPMC13212489

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.