{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T23:40:05Z","timestamp":1758670805215,"version":"3.44.0"},"reference-count":56,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>After anterior cruciate ligament reconstruction (ACLR), patients have been found to have\n        reduced plantar sensation, which may result in reduced afferent input to the central nervous\n        system and thus contribute to motor deficits. Textured surfaces are thought to have a\n        beneficial neurosensory effect. The aim of this cross-sectional study was to compare plantar\n        sensation and leg muscle activity while stepping on different textured surfaces between\n        patients after ACLR and healthy controls.<\/jats:p><jats:p>Plantar cutaneous thresholds to light touch were measured in 10 patients at least 6\n        months after ACLR and in 10 healthy controls. Patients or controls were asked to step\n        forward on the centre of a force plate with the affected (ACLR) or randomly assigned\n        (healthy controls) leg and maintain the single-legged stance for 10 seconds (floor\n        condition). They were instructed to perform the same task on a balance board with a textured\n        surface, the same balance board with a smooth surface, and a balance pad in random order.\n        Muscle activity of four leg muscles was recorded using surface electromyography. The\n        significance of differences in plantar sensation and mean muscle activity within three time\n        frames between and within ACLR patients and healthy controls was analysed using\n        non-parametric statistical tests with Bonferroni correction (p\u00a0&lt;\u00a00.05).<\/jats:p><jats:p>There were no significant differences between patients with ACLR and healthy controls in\n        plantar sensation and muscle activity for all unstable surface conditions (p\u00a0&gt;\u00a00.05). Friedman tests revealed significant differences in the\n        activities of all muscles between surface conditions at the first peak of the vertical\n        ground reaction force (vGRF) after the rapid increase in the force-time curve (transition\n        from early lifting phase to late lifting phase) within both groups (p\u00a0&lt;\u00a00.01). Post-hoc Wilcoxon signed-rank tests showed significantly altered\n        activity for most muscles between the smooth and textured balance board conditions only at\n        the first vGRF peak (p\u00a0\u2264\u00a00.01) in both patients and healthy\n        controls.<\/jats:p><jats:p>Although plantar sensation and muscle activity did not differ between patients with ACLR\n        and healthy controls, altered muscle activity in both groups, especially during the\n        transition from the early to the late lifting phase of stepping on a textured unstable\n        surface, may indicate an acute change in the afferent input of plantar mechanoreceptors in\n        response to the surface stimulus. In addition, it may indicate an acute change in motor\n        output caused by a beneficial neurosensory effect. This effect should be considered with\n        caution due to the small sample size.<\/jats:p>","DOI":"10.1055\/a-2577-7304","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T18:38:56Z","timestamp":1745865536000},"page":"432-442","source":"Crossref","is-referenced-by-count":0,"title":["Plantar Sensation and Muscle Activity During a Step on Various Textured Unstable Surfaces in Patients with Anterior Cruciate Ligament Reconstruction \u2013 Comparison with Healthy Controls"],"prefix":"10.1055","volume":"163","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-9814","authenticated-orcid":false,"given":"Martin","family":"Alfuth","sequence":"additional","affiliation":[{"name":"Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Pl\u00fccken","sequence":"additional","affiliation":[{"name":"Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Klemp","sequence":"additional","affiliation":[{"name":"Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilhelm","family":"Bloch","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Research and Sport Medicine, Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1007\/s00113-023-01357-2","article-title":"[Treatment of acute injury of the anterior cruciate ligament: Always only\n          reconstruction?]","volume":"127","author":"M Haner","year":"2024","journal-title":"Unfallchirurgie (Heidelb)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1502","DOI":"10.1177\/0363546516629944","article-title":"Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year\n          Population-Based Study","volume":"44","author":"TL Sanders","year":"2016","journal-title":"Am J Sports Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1007\/s00221-023-06751-1","article-title":"Corticomuscular cross-recurrence analysis reveals between-limb differences in\n          motor control among individuals with ACL reconstruction","volume":"242","author":"CD Riehm","year":"2024","journal-title":"Exp Brain Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1249\/MSS.0000000000002881","article-title":"Identifying Gait Pathology after ACL Reconstruction Using Temporal Characteristics\n          of Kinetics and Electromyography","volume":"54","author":"N Ito","year":"2022","journal-title":"Med Sci Sports Exerc"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"5103","DOI":"10.1113\/JP282014","article-title":"Deficit in knee extension strength following anterior cruciate ligament\n          reconstruction is explained by a reduced neural drive to the vasti muscles","volume":"599","author":"S Nuccio","year":"2021","journal-title":"J Physiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1016\/s0003-9993(03)00147-3","article-title":"Proprioceptive and behavior impairments in individuals with anterior cruciate\n          ligament reconstructed knees","volume":"84","author":"TR Bonfim","year":"2003","journal-title":"Arch Phys Med Rehabil"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1123\/jsr.2019-0154","article-title":"Decreased Postural Control in Patients Undergoing Anterior Cruciate Ligament\n          Reconstruction Compared to Healthy Controls","volume":"29","author":"JR Staples","year":"2020","journal-title":"J Sport Rehabil"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/j.rehab.2009.02.006","article-title":"Single-leg assessment of postural stability and knee functional outcome two years\n          after anterior cruciate ligament reconstruction","volume":"52","author":"A Zouita Ben Moussa","year":"2009","journal-title":"Ann Phys Rehabil Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"331","DOI":"10.3390\/diagnostics12020331","article-title":"Anterior and Posterior Cruciate Ligaments Mechanoreceptors: A Review of Basic\n          Science","volume":"12","author":"K Banios","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.neubiorev.2009.08.004","article-title":"The cutaneous sensory system","volume":"34","author":"F McGlone","year":"2010","journal-title":"Neurosci Biobehav Rev"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2980","DOI":"10.1152\/jn.2000.83.5.2980","article-title":"Abeta fibers mediate cutaneous reflexes during human walking","volume":"83","author":"BM van Wezel","year":"2000","journal-title":"J Neurophysiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"3795","DOI":"10.1152\/jn.00359.2005","article-title":"Evidence for strong synaptic coupling between single tactile afferents from the\n          sole of the foot and motoneurons supplying leg muscles","volume":"94","author":"JB Fallon","year":"2005","journal-title":"J Neurophysiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.neulet.2005.08.060","article-title":"Evaluation of age-related plantar-surface insensitivity and onset age of advanced\n          insensitivity in older adults using vibratory and touch sensation tests","volume":"392","author":"SD Perry","year":"2006","journal-title":"Neurosci Lett"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.gaitpost.2020.08.117","article-title":"Gait and plantar sensation changes following massage and textured insole\n          application in patients after anterior cruciate ligament reconstruction","volume":"81","author":"KA Collins","year":"2020","journal-title":"Gait Posture"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1002\/mus.25167","article-title":"Somatosensory deficits in post-ACL reconstruction patients: A case-control\n          study","volume":"55","author":"JM Hoch","year":"2017","journal-title":"Muscle Nerve"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1123\/jsr.21.1.1","article-title":"Altered plantar-receptor stimulation impairs postural control in those with\n          chronic ankle instability","volume":"21","author":"PO McKeon","year":"2012","journal-title":"J Sport Rehabil"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1177\/1941738114565088","article-title":"Unstable Surface Improves Quadriceps:Hamstring Co-contraction for Anterior\n          Cruciate Ligament Injury Prevention Strategies","volume":"7","author":"R Shultz","year":"2015","journal-title":"Sports Health"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"737","DOI":"10.2522\/ptj.20060041","article-title":"Neuromuscular training versus strength training during first 6 months after\n          anterior cruciate ligament reconstruction: a randomized clinical trial","volume":"87","author":"MA Risberg","year":"2007","journal-title":"Phys Ther"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1177\/036354658701500302","article-title":"The synergistic action of the anterior cruciate ligament and thigh muscles in\n          maintaining joint stability","volume":"15","author":"M Solomonow","year":"1987","journal-title":"Am J Sports Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1177\/03635465010290011801","article-title":"Direct evidence of the anterior cruciate ligament-hamstring reflex arc in\n          humans","volume":"29","author":"E Tsuda","year":"2001","journal-title":"Am J Sports Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1007\/s00421-004-1080-y","article-title":"Impact of sensorimotor training on the rate of force development and neural\n          activation","volume":"92","author":"M Gruber","year":"2004","journal-title":"Eur J Appl Physiol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"993","DOI":"10.26603\/ijspt20180993","article-title":"The Influence of Sensorimotor Training Modalities on Balance, Strength, Joint\n          Function, and Plantar Foot Sensitivity in Recreational Athletes with a History of Ankle\n          Sprain: A Randomized Controlled Pilot Study","volume":"13","author":"S Deussen","year":"2018","journal-title":"Int J Sports Phys Ther"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1123\/jsr.2018-0052","article-title":"Effects of Textured Balance Board Training in Adolescent Ballet Dancers With Ankle\n          Pathology","volume":"28","author":"N Steinberg","year":"2019","journal-title":"J Sport Rehabil"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"14092","DOI":"10.3390\/ijerph192114092","article-title":"Validity and Reliability of Criteria for Plantar Sensation Assessment Using\n          Semmes-Weinstein Monofilament as a Clinically Usable Index","volume":"19","author":"M Nakamoto","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.neulet.2011.09.037","article-title":"Are diurnal changes in foot sole sensation dependent on gait activity?","volume":"504","author":"M Alfuth","year":"2011","journal-title":"Neurosci Lett"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.gaitpost.2020.12.014","article-title":"Biomechanical analysis of single-leg stance using a textured balance board\n          compared to a smooth balance board and the floor: A cross-sectional study","volume":"84","author":"M Alfuth","year":"2021","journal-title":"Gait Posture"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.ptsp.2018.01.002","article-title":"Electromyographic analysis of balance exercises in single-leg stance using\n          different instability modalities of the forefoot and rearfoot","volume":"31","author":"M Alfuth","year":"2018","journal-title":"Phys Ther Sport"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"193","DOI":"10.5604\/01.3001.0014.9157","article-title":"Analysis of Vastus Lateralis and Vastus Medialis Activities in Men the Late\n          Post-Surgery Period after ACL Reconstruction with LARS Synthetic Ligament","volume":"23","author":"A Bejer","year":"2021","journal-title":"Ortop Traumatol Rehabil"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"740","DOI":"10.4085\/1062-6050-49.3.46","article-title":"Quadriceps muscle function after exercise in men and women with a history of\n          anterior cruciate ligament reconstruction","volume":"49","author":"CM Kuenze","year":"2014","journal-title":"J Athl Train"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.knee.2022.05.003","article-title":"Alteration of quadriceps muscle activity during functional step tasks after\n          extended sitting session","volume":"37","author":"D Sondang Irawan","year":"2022","journal-title":"Knee"},{"key":"ref32","first-page":"54","volume-title":"Detection and Conditioning of Surface EMG Signals","author":"R Merletti","year":"2016"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1109\/TNSRE.2022.3163130","article-title":"Gait Phase Subdivision and Leg Stiffness Estimation During Stair\n          Climbing","volume":"30","author":"T Ma","year":"2022","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)\n          statement: guidelines for reporting observational studies","volume":"61","author":"E von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s13102-019-0117-9","article-title":"The effects of textured insoles on quiet standing balance in four stance types\n          with and without vision","volume":"11","author":"RPW Kenny","year":"2019","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2023.1112708","article-title":"Relationship of strength, joint kinesthesia, and plantar tactile sensation to\n          dynamic and static postural stability among patients with anterior cruciate ligament\n          reconstruction","volume":"14","author":"S Hu","year":"2023","journal-title":"Front Physiol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.ptsp.2019.01.002","article-title":"Examination of ankle function in individuals with a history of ACL\n          reconstruction","volume":"36","author":"JM Hoch","year":"2019","journal-title":"Phys Ther Sport"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.ptsp.2023.09.007","article-title":"Test-retest reliability of quantitative sensory testing, active joint position\n          sense, and functional hop testing in amateur adult athletes with unilateral anterior\n          cruciate ligament reconstruction","volume":"64","author":"DJ Kempfert","year":"2023","journal-title":"Phys Ther Sport"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"2151","DOI":"10.1177\/0363546509337698","article-title":"Assessment of differences between the modified Cincinnati and International Knee\n          Documentation Committee patient outcome scores: a prospective study","volume":"37","author":"J Agel","year":"2009","journal-title":"Am J Sports Med"},{"issue":"S 11","key":"ref40","doi-asserted-by":"publisher","first-page":"S208","DOI":"10.1002\/acr.20632","article-title":"Measures of knee function: International Knee Documentation Committee (IKDC)\n          Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee\n          Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee\n          Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale,\n          Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index\n          (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS)","volume":"63","author":"NJ Collins","year":"2011","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1007\/s00167-018-5189-7","article-title":"Anterior cruciate ligament reconstruction improves subjective ability but not\n          neuromuscular biomechanics during dynamic tasks","volume":"27","author":"KB Smale","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.ptsp.2015.05.001","article-title":"Muscle activity of leg muscles during unipedal stance on therapy devices with\n          different stability properties","volume":"17","author":"T Wolburg","year":"2016","journal-title":"Phys Ther Sport"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1007\/s00221-024-06904-w","article-title":"The suppression of lower leg electromyography when walking in textured foot\n          orthoses","volume":"242","author":"KA Robb","year":"2024","journal-title":"Exp Brain Res"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s00221-023-06758-8","article-title":"Capitalizing on skin in orthotics design: the effects of texture on plantar\n          intrinsic foot muscles during locomotion","volume":"242","author":"KA Robb","year":"2024","journal-title":"Exp Brain Res"},{"volume-title":"Anatomy, Bony Pelvis and Lower Limb: Tibial Nerve","year":"2025","author":"SS Desai","key":"ref45"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1007\/s00276-024-03329-6","article-title":"Tibial nerve branching pattern and compatibility of branches for the deep fibular\n          nerve","volume":"46","author":"M Yilmaz","year":"2024","journal-title":"Surg Radiol Anat"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1590\/S1413-78522012000300005","article-title":"Study of the anatomy of the tibial nerve and its branches in the distal medial\n          leg","volume":"20","author":"AL Torres","year":"2012","journal-title":"Acta Ortop Bras"},{"volume-title":"Anatomy, Bony Pelvis and Lower Limb: Sural Nerve","year":"2025","author":"MA Miniato","key":"ref48"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s00167-005-0679-9","article-title":"Anatomy of the anterior cruciate ligament","volume":"14","author":"VB Duthon","year":"2006","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"11","DOI":"10.2519\/jospt.2002.32.1.11","article-title":"The effect of bracing on proprioception of knees with anterior cruciate ligament\n          injury","volume":"32","author":"BD Beynnon","year":"2002","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s00276-024-03371-4","article-title":"Innervation patterns of hamstring muscles, including morphological descriptions\n          and clinical implication","volume":"46","author":"E Farfan","year":"2024","journal-title":"Surg Radiol Anat"},{"key":"ref52","first-page":"17","article-title":"Das neuromuskul\u00e4re Defizit nach Ruptur des vorderen Kreuzbandes \u2013 Aktuelle\n          wissenschaftliche Ergebnisse","volume":"56","author":"F Von L\u00fcbken","year":"2008","journal-title":"Schweiz Zeitschr Sportmed Sporttraumatol"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1152\/jn.00529.2006","article-title":"Changes in stretch reflex excitability are related to \u201cgiving way\u201d symptoms in\n          patients with anterior cruciate ligament rupture","volume":"97","author":"M Melnyk","year":"2007","journal-title":"J Neurophysiol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1016\/j.clinbiomech.2011.05.003","article-title":"Kinematic evaluation of the step-up exercise in anterior cruciate ligament\n          deficiency","volume":"26","author":"M Kozanek","year":"2011","journal-title":"Clin Biomech (Bristol)"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1097\/NPT.0b013e31818dee39","article-title":"Sensory reweighting as a method of balance training for labyrinthine\n          loss","volume":"32","author":"FJ Haran","year":"2008","journal-title":"J Neurol Phys Ther"},{"key":"ref56","volume-title":"Motor Control. Translating Research into Clinical Practice","author":"A Shumway-Cook","year":"2012","edition":"4"},{"key":"ref57","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1093\/ptj\/80.5.485","article-title":"A guide for use and interpretation of kinesiologic electromyographic\n          data","volume":"80","author":"GL Soderberg","year":"2000","journal-title":"Phys Ther"}],"container-title":["Zeitschrift f\u00fcr Orthop\u00e4die und Unfallchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2577-7304.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T23:04:51Z","timestamp":1758668691000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2577-7304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":56,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2025,9,23]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2577-7304","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1864-6697","1864-6743"],"issn-type":[{"type":"print","value":"1864-6697"},{"type":"electronic","value":"1864-6743"}],"subject":[],"published":{"date-parts":[[2025,4,28]]}}}