Evidence map›Paper›PMID 42710345›Full record

ArticleClinical biomechanics (Bristol, Avon)2026

Increasing dynamic limb-level loading via real-time biofeedback decreases cumulative loading impulse during gait post-anterior cruciate ligament reconstruction.

Ashley N Buck, Cortney Armitano-Lago, Elizabeth S Bjornsen, Hope Davis-Wilson, Alyssa Evans-Pickett, Amanda E Munsch, Todd A Schwartz, Jason R Franz, Brian Pietrosimone

Abstract read
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In one paragraph

Article in Clinical biomechanics (Bristol, Avon), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ashley N BuckHuman Movement Science Curriculum, University of North Carolina at Chapel Hill, 209 Fetzer Hall, Chapel Hill, NC 27514, USA; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 209 Fetzer Hall, Chapel Hill, NC 27514, USA; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Thurston-Bowles Building, Chapel Hill, NC 27599, USA; Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin - Madison, 1685 Highland Avenue, Madison, WI 53705, USA. Electronic address: ashley.buck@wisc.edu.
Cortney Armitano-LagoDepartment of Exercise and Sport Science, University of North Carolina at Chapel Hill, 209 Fetzer Hall, Chapel Hill, NC 27514, USA; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Thurston-Bowles Building, Chapel Hill, NC 27599, USA. Electronic address: Cortney_lago@med.unc.edu.
Elizabeth S BjornsenLampe Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 116 Manning Dr, Chapel Hill, NC 27599, USA. Electronic address: ebjornse@email.unc.edu.
Hope Davis-WilsonResearch Triangle International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, USA. Electronic address: hdaviswilson@rti.org.
Alyssa Evans-PickettDepartment of Exercise and Sport Science, University of North Carolina at Chapel Hill, 209 Fetzer Hall, Chapel Hill, NC 27514, USA.
Amanda E MunschLampe Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 116 Manning Dr, Chapel Hill, NC 27599, USA. Electronic address: aemunsch@live.unc.edu.
Todd A SchwartzThurston Arthritis Research Center, University of North Carolina at Chapel Hill, Thurston-Bowles Building, Chapel Hill, NC 27599, USA; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599, USA; Department of Biostatistics, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, 3101, Chapel Hill, NC 27599, USA. Electronic address: tschwart@email.unc.edu.
Jason R FranzThurston Arthritis Research Center, University of North Carolina at Chapel Hill, Thurston-Bowles Building, Chapel Hill, NC 27599, USA; Lampe Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 116 Manning Dr, Chapel Hill, NC 27599, USA. Electronic address: jrfranz@email.unc.edu.
Brian PietrosimoneDepartment of Exercise and Sport Science, University of North Carolina at Chapel Hill, 209 Fetzer Hall, Chapel Hill, NC 27514, USA; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Thurston-Bowles Building, Chapel Hill, NC 27599, USA. Electronic address: pietrosi@email.unc.edu.

Funding

UNC Core Center for Clinical ResearchP30AR072580 · NIAMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI LEIGH Fleming CALLAHAN, Amanda E Nelson · 2019 to 2026
$6.1M
The Rheumatic and Musculoskeletal Disease Epidemiology and Outcomes Training Program at the University of North CarolinaT32AR082310 · NIAMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI LEIGH Fleming CALLAHAN, Amanda E Nelson · 2024 to 2026
$616k
In vivo Manipulation of Mechanical Loading: Using Real-time Biofeedback to Strategically Understand the Acute Biomechanical, Biochemical and Structural Changes Induced by Lower Extremity LoadingR21AR074094 · NIAMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI FRANZ, JASON R, PIETROSIMONE, BRIAN · 2018 to 2019
$357k
NIAMS NIH HHS P30 AR072580NIAMS NIH HHS R21 AR074094NIAMS NIH HHS T32 AR082310
6 · The paper itself

Abstract

backgroundDynamic gait loading patterns (greater peak vertical ground reaction force [vGRF]; lesser midstance vGRF) are associated with better outcomes post-anterior cruciate ligament reconstruction (ACLR). Real-time gait biofeedback (RTGBF) can elicit dynamic loading patterns by cuing an increase in peak vGRF; however, effects on cumulative limb-level loading and joint-moment impulses remain unclear. We determined the effects of cuing increases and decreases in peak vGRF via RTGBF on stance phase vGRF impulse, and absolute sagittal- and frontal-plane knee-moment impulses in individuals 6-12 months post-ACLR.

methodsThirty-nine individuals (46% male; 21 ± 4 years; 24.7 ± 3.2 kg/m

findingsvGRF impulse was significantly lower (p = 0.03) during dynamic loading compared with sustained loading (0.51 ± 0.07 vs 0.54 ± 0.06 BW·s). No statistically significant differences were detected in absolute sagittal- (0.15 ± 0.04 vs 0.17 ± 0.10 Nm/kg·s) and frontal-plane (0.07 ± 0.04 vs 0.07 ± 0.04 Nm/kg·s) knee-moment impulses.

interpretationCuing increased peak vGRF resulted in lower cumulative limb-level compressive loading and no statistically significant differences in absolute knee-moment impulses were detected. The clinical significance of the observed vGRF impulse difference remains unknown as no established clinically meaningful threshold exists. It does seem clear from our findings that on average promoting dynamic loading via RTGBF in future gait-retraining studies will not substantially increase the overall impulsive loading applied to the limb during each step.

Indexed as

Anterior Cruciate Ligament ReconstructionBiofeedback, PsychologyGaitAdultAnterior Cruciate LigamentBiomechanical PhenomenaFemaleHumansKnee JointMaleWeight-BearingYoung AdultACLRGait retrainingJoint momentsVertical ground reaction force

Identifiers

PMID42710345
PMCPMC13643601

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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.