BAROPODOMETRIC ASSESSMENT OF PLANTAR BIOMECHANICS AND POSTURAL STABILITY FOLLOWING STATIC VERSUS DYNAMIC BALANCE TRAINING IN POST- ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION PATIENTS: AN EXPERIMENTAL INVESTIGATION

Abstract

Background: anterior cruciate ligament (ACL) reconstruction impaired the proprioception and neuromuscular system
that control dynamic knee stability resulting in characteristic pattern of planter pressure asymmetry, postural sway
elevation, and altered mechanical loading that persist long into the post operative rehabilitation period. Baropadometry -
the objective qualification of the planter pressure distribution and postural parameters using a pressure sensitive sensor
plate - offer a reliable and valid tool sensitive for detecting these biomechanical deficits and monitoring rehabilitation
induced correction. While both stating and dynamic balance training are recognized rehabilitation exercise for post ACL
reconstruction patient, no study has symmetrically compared their differential effect on comprehensive baropadometric
outcomes within a controlled experimental design. This study is design to address this gap.
Methods: An Experimental, two groups, pre-test and post-test comparative study was conducted at the Department Of
Physiotherapy, Pacific Medical College and Hospital, Udaipur. 30 post ACL reconstruction patient were divided into
Group A ( Static Balance Training n = 15) and Group B ( Dynamic Balance Training n = 15 ). Both groups received
there respective intervention for 6 days per week for 4 weeks. Seven baropadometric parameter- Baropadometric index
(%), Load Distribution (%), Mean Planter Pressure (kPa), Peak plantar pressure (%) ,Foot Barycenter (mm²), Body
Barycenter (mm²),, and Centre Of Pressure (COP) Distance (mm)- were assessed using a Baropadometric sensory plate
at baseline and post intervention. Re assessment was performed every third day to guide individualized protocol
progression. Statistical analysis employed paired t – test for within group and independent t – test for between group
comparison (significance p < 0.05)
Results : both groups demonstrated highly significant improvement in all seven baropadometric parameter (p < 0.001
for all). Group A (Static) achieved post intervention means of baropadometric index 52.56 ± 1.88%, Load Distribution
46.89 ± 2.35%, Mean Pressure 157.23 ± 8.76 kPa, Peak Pressure 270.0 ± 14.12 kPa, Foot Barycenter 35.64 ± 3.38 mm²,
Body Barycenter 48.01 ± 3.84 mm², and COP Distance 19.62 ± 3.46 mm. Group B (Dynamic) achieved superior
outcomes across all seven parameters: Baropadometric Index 53.68 ± 1.21%, Load Distribution 45.36 ± 1.31%, Mean
Pressure 151.52 ± 4.70 kPa, Peak Pressure 261.46 ± 7.93 kPa, Foot Barycenter 35.98 ± 1.60 mm², Body Barycenter
45.43 ± 1.98 mm², and COP Distance 17.06 ± 1.60 mm. Standard deviation were consistently lower in group B which
reflect superior consistency of bio mechanical adaptation.
Conclusion : Both static and dynamic balance training produce comprehensive, clinically sufficient improvement,
baropadometric parameter Following ACL reconstruction. Dynamic balance training demonstrated superior
biomechanical outcomes across all seven parameter assessed with greater reduction in postural sway, more symmetrical
planted distribution, and more consistent inter- individual adaptation. Baropadometric assessment is validated as a
sensitive and objective tool for monitoring post ACL reconstruction rehabilitation progress and guide individualized
program to get better progression