Characterizing body composition, cardiorespiratory fitness, and physical activity in women with anterior cruciate ligament reconstruction

2021 ◽  
Vol 48 ◽  
pp. 54-59
Author(s):  
Ashley N. Triplett ◽  
Christopher M. Kuenze
2020 ◽  
Vol 55 (9) ◽  
pp. 994-1000
Author(s):  
Caroline M. Lisee ◽  
Alexander H.K. Montoye ◽  
Noble F. Lewallen ◽  
Mayrena Hernandez ◽  
David R. Bell ◽  
...  

Context Anterior cruciate ligament reconstruction (ACLR) and gait speed are risk factors for developing knee osteoarthritis (OA). Measuring minute-level cadence during free-living activities may aid in identifying individuals at elevated risk of developing slow habitual gait speed and, in the long term, OA. Objective To assess differences in peak 1-minute cadence and weekly time in different cadence intensities between individuals with and without ACLR. Design Cross-sectional study. Setting Short-term, free-living conditions. Patients or Other Participants A total of 57 participants with ACLR (34 women, 23 men; age = 20.9 ± 3.2 years, time since surgery = 28.7 ± 17.7 months) and 42 healthy control participants (22 women, 20 men; age = 20.7 ± 1.7 years). Main Outcome Measure(s) Each participant wore a physical activity monitor for 7 days. Data were collected at 30 Hz, processed in 60-second epochs, and included in the analyses if the activity monitor was worn for at least 10 hours per day over 4 days. Mean daily steps, peak 1-minute cadence, and weekly minutes spent at 60 to 79 (slow walking), 80 to 99 (medium walking), 100 to 119 (brisk walking), ≥100 (moderate- to vigorous-intensity ambulation), and ≥130 (vigorous-intensity ambulation) steps per minute were calculated. One-way analyses of covariance were conducted to determine differences between groups, controlling for height and activity-monitor wear time. Results Those with ACLR took fewer daily steps (8422 ± 2663 versus 10 033 ± 3046 steps; P = .005) and spent fewer weekly minutes in moderate- to vigorous-intensity cadence (175.8 ± 116.5 minutes versus 218.5 ± 137.1 minutes; P = .048) than participants without ACLR. We observed no differences in minutes spent at slow (ACLR = 77.4 ± 40.5 minutes versus control = 83.9 ± 34.3 minutes; P = .88), medium (ACLR = 71.6 ± 40.2 minutes versus control = 82.9 ± 46.8 minutes; P = .56), brisk (ACLR = 115.3 ± 70.3 minutes versus control = 138.3 ± 73.3 minutes; P = .18), or vigorous-intensity (ACLR = 24.3 ± 36.5 minutes versus control = 38.1 ± 60.9 minutes; P = .10) cadences per week. Conclusions Participants with ACLR walked approximately 40 fewer minutes per week in moderate- to vigorous-intensity cadence than participants without ACLR. Increasing the time spent at cadence ≥100 steps per minute and overall volume of physical activity may be useful as interventional targets to help reduce the risk of early development of OA after ACLR.


2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0052
Author(s):  
Hayley M. Carter ◽  
Kate E. Webster ◽  
Benjamin E. Smith

Introduction: The optimum time to surgery following ACL rupture remains an outstanding clinical problem. Recent data for the average wait time for an ACLR in the UK is not currently available and anecdotally times range from 4-12 months before an individual undergoes surgery. Globally, the length of time available for preoperative rehabilitation (commonly termed prehabilitation) will vary widely; it is also unknown which subset of patients receive or do not receive prehabilitation and reasons behind this decision making. The current evidence base presents only a small number of RCTs exploring ACL prehabilitation, with inconsistent results on pre- and post-operative outcomes such as muscular strength and function when compared with no prehabilitation. Programmes also vary in content, duration and frequency. Currently, there is no agreed consensus on the best approach to this stage of rehabilitation for this patient group, and thus, current practice is unknown. Hypotheses: This study aimed to explore the current physiotherapy management strategies used during the preoperative phase of rehabilitation for patients awaiting anterior cruciate ligament reconstruction (ACLR). Methods: An anonymous survey was disseminated online via Twitter and the ‘interactive Chartered Society of Physiotherapy’ message board. Practising physiotherapists who treated at least one patient prior to ACLR in the past year were invited to take part. Responses were collected over a 4-week period in March 2020. Data were analysed using descriptive statistics. Results: In total, 183 respondents replied; 122 completed the full survey. Responses were collected from 20 countries across 3 settings, NHS/public health services, private and sports. Most respondents reported prescribing exercises, advice and education to patients during prehabilitation. Up to 40% also utilised passive treatments including manual therapy, taping/bracing and electrotherapy. The frequency of recommended exercise completion and length of treatment varied. Most respondents (n=103/84.4%) felt that many patients waiting for ACLR did not receive prehabilitation. Many physiotherapists reported that patients expressed concerns regarding their readiness for surgery (n=61/50%) and return to preinjury levels of physical activity (n=112/91.8%). Almost all respondents would discuss non-operative management with patients (n=112/91.8%) if they had returned to their preinjury level of physical activity before their ACLR. Conclusion: Overall, this survey provides some insight as to how physiotherapists manage patients awaiting ACLR. Areas of uncertainty in physiotherapy practice have also been highlighted that require further high-quality research.


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