Effects of BMI on Walking Speed and Gait Biomechanics after Anterior Cruciate Ligament Reconstruction

Hope C. Davis-Wilson, Christopher D. Johnston, Emma Young, Kyeongtak Song, Erik A. Wikstrom, J. Troy Blackburn, Brian Pietrosimone

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Purpose History of an anterior cruciate ligament reconstruction (ACLR) and high body mass index (BMI) are strong independent risk factors for knee osteoarthritis (KOA) onset. The combination of these risk factors may further negatively affect joint loading and KOA risk. We sought to determine the combined influence of BMI and ACLR on walking speed and gait biomechanics that are hypothesized to influence KOA onset. Methods Walking speed and gait biomechanics (peak vertical ground reaction force [vGRF], peak vGRF instantaneous loading rate [vGRF-LR], peak knee flexion angle, knee flexion excursion [KFE], peak internal knee extension moment [KEM], and peak internal knee abduction moment [KAM]) were collected in 196 individuals with unilateral ACLR and 106 uninjured controls. KFE was measured throughout stance phase, whereas all other gait biomechanics were analyzed during the first 50% of stance phase. A 2 × 2 ANOVA was performed to evaluate the interaction between BMI and ACLR and main effects for both BMI and ACLR on walking speed and gait biomechanics between four cohorts (high BMI ACLR, normal BMI ACLR, high BMI controls, and normal BMI controls). Results History of an ACLR and high BMI influenced slower walking speed (F1,298 = 7.34, P = 0.007), and history of an ACLR and normal BMI influenced greater peak vGRF-LR (F1,298 = 6.56, P = 0.011). When evaluating main effects, individuals with an ACLR demonstrated lesser KFE (F1,298 = 7.85, P = 0.005) and lesser peak KEM (F1,298 = 6.31, P = 0.013), and individuals with high BMI demonstrated lesser peak KAM (F1,297 = 5.83, P = 0.016). Conclusion BMI and history of ACLR together influence walking speed and peak vGRF-LR. History of an ACLR influences KFE and peak KEM, whereas BMI influences peak KAM. BMI may need to be considered when designing interventions aimed at restoring gait biomechanics post-ACLR.

Original languageEnglish
Pages (from-to)108-114
Number of pages7
JournalMedicine and Science in Sports and Exercise
Issue number1
Publication statusPublished - 2021

Bibliographical note

Funding Information:
The current study was funded by grants from 1) the National Athletic Trainers Association Research and Education Foundation (New Investigator Research Grant Award, 14NewInv001); 2) the North Carolina Translational and Clinical Sciences (TraCS) Institute Planning Grant, National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases (1R03AR066840-01A1); and 3) the U.S. Department of Defense Clinical and Rehabilitative Medicine Research Program, Neuromusculoskeletal Injuries Research Award (W81XWH-15-1-0287).

Publisher Copyright:
© Lippincott Williams & Wilkins.

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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