{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T11:09:41Z","timestamp":1778324981838,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003977","name":"Israel Science Foundation","doi-asserted-by":"publisher","award":["466\/22"],"award-info":[{"award-number":["466\/22"]}],"id":[{"id":"10.13039\/501100003977","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&R"],"published-print":{"date-parts":[[2025,6]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Despite advancements in anterior cruciate ligament reconstruction (ACLR), achieving symmetrical movement patterns during stair negotiation remains challenging. Therefore, this study examines lower limb kinematics during stair ambulation at the early and mid\u2010rehabilitation stages after ACLR in a real\u2010world environment.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To describe lower limb kinematics during stair ambulation at 3 and 5 months after ACLR and evaluate changes between these time points. We hypothesized that between\u2010limb asymmetries would improve over this period.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Longitudinal study.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n Twenty\u2010seven patients 3 months post ACLR were recruited, and 18 were followed up at 5 months post ACLR. Surgeries were performed by one of five surgeons using various grafts (hamstrings, bone\u2010patellar tendon\u2010bone, or quadriceps). Exclusion criteria were multiligament injuries, major meniscus injuries, other concomitant injuries, or previous knee surgeries. An additional group of matched healthy controls (\n n<\/jats:italic>\n \u2009=\u200916) was also recruited.\n <\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Public health care campus.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n N\/A.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Maximum and minimum joint angles, and continuous kinematic patterns during stair ascent and descent were measured on a 20\u2010step staircase at self\u2010selected speed using seven inertial measurement units, with sagittal knee kinematics as the main outcome and hip and ankle kinematics as secondary outcomes. Between\u2010limb differences and longitudinal changes were analyzed using discrete points and statistical parametric mapping.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At 3 months after ACLR, the injured knee was less flexed compared to the contralateral knee during stair ascent (mean difference\u2009=\u2009\u221211.3\u00b0, confidence interval [CI, \u221214.4 to \u22128.1],\n p<\/jats:italic>\n \u2009<\u2009.001) and descent (mean difference\u2009=\u2009\u22126.3\u00b0, CI [\u221210.2 to \u22122.4],\n p<\/jats:italic>\n \u2009=\u2009.002). Statistical parametric mapping analysis showed decreased flexion at 0%\u201335% and 87%\u201399% of the stair ascent cycle (\n p<\/jats:italic>\n \u2009<\u2009.005). By 5 months, flexion differences during ascent improved (mean difference\u2009=\u2009\u22124.7\u00b0, CI [\u22128.1 to \u22121.4],\n p<\/jats:italic>\n \u2009=\u2009.008), but asymmetry persisted, with decreased flexion at 10%\u201332% of the cycle during ascent and 20%\u201329% during descent (\n p<\/jats:italic>\n \u2009<\u2009.017). Flexion improvements were observed from 3 to 5 months during ascent (mean increase\u2009=\u20096.1\u00b0,\n p<\/jats:italic>\n \u2009<\u2009.001) and descent (mean increase\u2009=\u20099.3\u00b0,\n p<\/jats:italic>\n \u2009=\u2009.004).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Persistent lower limb kinematic asymmetries remain 5 months after ACLR during stair ambulation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pmrj.13342","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T02:13:55Z","timestamp":1741745635000},"page":"663-672","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lower limb kinematic changes during stair navigation 3 and 5\u2009months after anterior cruciate ligament reconstruction: A longitudinal analysis in real\u2010world settings"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4809-490X","authenticated-orcid":false,"given":"Tomer","family":"Yona","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Technion, Israel Institute of Technology Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bezalel","family":"Peskin","sequence":"additional","affiliation":[{"name":"Orthopedic Department Rambam Medical Center Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4493-5222","authenticated-orcid":false,"given":"Arielle G.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Technion, Israel Institute of Technology Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279\u2010016\u20100510\u20104"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4085\/1062\u20106050\u2010334\u201016"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2021.03.013"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2019.01.029"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2016.12.005"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279\u2010019\u201001222\u20106"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000741"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221095236"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2015.11.013"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010200210000\u201000025"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2024.01.018"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/10255842.2010.527837"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u20108\u2010200710160\u201000010"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/s18030719"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3758\/bf03193146"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201013\u201092"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2020.08.003"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jeo2.12017"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241228543"}],"container-title":["PM&R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.13342","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmrj.13342","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.13342","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T10:42:27Z","timestamp":1778323347000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.13342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,1]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/pmrj.13342"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.13342","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,1]]},"assertion":[{"value":"2024-10-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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