{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:06:46Z","timestamp":1779696406406,"version":"3.53.1"},"reference-count":60,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100012283","name":"chiayi chang gung memorial hospital","doi-asserted-by":"publisher","award":["CMRPG6N0392-3"],"award-info":[{"award-number":["CMRPG6N0392-3"]}],"id":[{"id":"10.13039\/501100012283","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Preoperative and postoperative asymmetries in knee kinematics and kinetics, particularly in vertical ground-reaction force (vGRF), have been linked to long-term functional outcomes after anterior cruciate ligament (ACL) reconstruction. Gait asymmetry may indicate altered neuromuscular control and compensatory cocontraction strategies, which can compromise joint integrity and delay recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine whether preoperative vGRF asymmetry could predict postoperative knee extensor strength symmetry and neuromuscular recovery 1 year after ACL reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 2<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 55 patients undergoing ACL reconstruction were prospectively evaluated before surgery and at 1 year postoperatively. Assessments included vGRF, gait speed, surface electromyography, isokinetic knee extensor\/flexor strength, and the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Based on preoperative vGRF data, participants were categorized into lesser-loading and greater-loading groups. Three-dimensional motion capture and synchronized force plates were used to analyze gait and cocontraction indices. Generalized estimating equations were applied to evaluate group \u00d7 time effects, with statistical significance set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Both groups demonstrated pain reduction and improved KOOS scores postoperatively, accompanied by partial restoration of vGRF symmetry. The greater-loading group (n = 28) exhibited significant improvement in knee extensor strength symmetry (from 66% to 87%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001), whereas the lesser-loading group (n = 27) showed persistent muscle cocontraction (0.12-0.12;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .94) and less improvement in knee extensor strength symmetry (from 67% to 75%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .11). These results indicate distinct neuromuscular adaptation patterns depending on preoperative loading asymmetry.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study showed that preoperative vGRF asymmetry is a clinically feasible indicator of neuromuscular recovery potential after ACL reconstruction. Patients with reduced injured-limb loading showed persistent cocontraction and weaker quadriceps strength, underscoring the value of early gait assessment for targeted rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671261442212","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:20:01Z","timestamp":1779452401000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Preoperative Asymmetry in Vertical Ground-Reaction Force With Knee Extensor Symmetry 1 Year After Anterior Cruciate Ligament Reconstruction"],"prefix":"10.1177","volume":"14","author":[{"given":"Chun-Hao","family":"Fan","sequence":"first","affiliation":[{"name":"Office of Students' Affairs, Yanshuei Elementary School, Tainan, Taiwan"},{"name":"Graduate Institute of Education, National Chung Cheng University, Chiayi, Taiwan"},{"name":"Department of Athletic Sports, National Chung Cheng University, Chiayi, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui-Hung","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7744-8646","authenticated-orcid":false,"given":"Wei-Hsiu","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"},{"name":"Sports Medicine Center, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"},{"name":"School of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-An","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"},{"name":"Sports Medicine Center, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Lung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"},{"name":"Sports Medicine Center, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Wen-Wei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"},{"name":"Sports Medicine Center, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.32598\/JROSJ.9.1.857.1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-093398"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2017.05.004"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3623-7"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb01132.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.jsm.0000188040.97135.43"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.26101"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2016.07.030"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2019.05.010"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001670050018"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13237251"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/85.8.740"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2008.2887"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511424134"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0333200"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2018.10.021"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.05.015"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2023.106059"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514552184"},{"issue":"4","key":"e_1_3_3_21_2","first-page":"441","article-title":"Return of normal gait as an outcome measurement in ACL reconstructed patients. 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