Closed and Open Kinetic Chain Exercise for the Upper Extremity

1996 ◽  
Vol 5 (1) ◽  
pp. 88-102 ◽  
Author(s):  
Kevin E. Wilk ◽  
Christopher A. Arrigo ◽  
James R. Andrews
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Glenohumeral Joint ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Kinetic Chain ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain ◽  
Anterior Cruciate ◽  
Scientific Rationale

The use of closed kinetic chain exercise has grown in the past several years. Closed kinetic chain exercises for the lower extremity have been firmly established in the literature and have been strongly recommended as an integral part of rehabilitation of the patient with anterior cruciate ligament injury. While the scientific and clinical rationale for using closed kinetic chain exercise for the lower extremity appears obvious, the scientific rationale for using closed kinetic chain exercise for the upper extremity is less clear. The purpose of this manuscript is to discuss the scientific rationale for closed kinetic chain for the upper extremity patient. In addition, exercise drills to enhance dynamic stability of the glenohumeral joint are discussed, and a rationale for using these exercises for specific glenohumeral joint pathologies is provided. The concepts of closed and open kinetic chain as applied to the lower extremity may not apply to the upper extremity due to the unique anatomical and biomechanical features as well as the function of the shoulder. It is recommended that clinicians use both closed kinetic chain and open kinetic chain exercises when treating the shoulder patient.

Kinetic Chain Exercise: Implications for the Anterior Cruciate Ligament Patient

1997 ◽  
Vol 6 (2) ◽  
pp. 125-143 ◽  
Author(s):  
Kevin E. Wilk ◽  
Naiquan Zheng ◽  
Glenn S. Fleisig ◽  
James R. Andrews ◽  
William G. Clancy
Keyword(s):  
Muscle Activity ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Rehabilitation Program ◽  
Hamstring Muscle ◽  
Kinetic Chain ◽  
Bearing Load ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain ◽  
Anterior Cruciate

Closed kinetic chain exercise has become popular in rehabilitation of the ACL patient. While many clinicians agree on the benefits of closed kinetic chain exercise, there is great discrepancy as to which exercises fit this category. This discrepancy stems from the fact that the kinetic chain concept was originally developed using mechanical engineering concepts and not human kinesiology. In this paper, the kinetic chain concept is redefined in a continuum of lower extremity exercises from closed kinetic chain to open kinetic chain. The placement of an exercise in this continuum is based upon joint kinematics, quadriceps and hamstring muscle activity, cruciate ligament stress, and joint weight-bearing load. An understanding of these factors can help the clinician design a comprehensive and effective rehabilitation program for the ACL patient.

scholarly journals Open versus Closed Kinetic Chain Exercises following an Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Daniel Jewiss ◽  
Cecilia Ostman ◽  
Neil Smart
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Kinetic Chain ◽  
Randomized Controlled ◽  
Open Kinetic Chain ◽  
Closed Kinetic Chain ◽  
Anterior Cruciate ◽  
Open Versus

Background. There is no consensus on whether closed kinetic chain (CKC) or open kinetic chain (OKC) exercises should be the intervention of choice following an anterior cruciate ligament (ACL) injury or reconstruction. Methods. A systematic search identified randomized controlled trials of OKC versus CKC exercise training in people who had undergone ACL reconstructive surgery. All published studies in this systematic review were comparisons between OKC and CKC groups. Results. Seven studies were included. Lysholm knee scoring scale was not significantly different between OKC and CKC exercise patients: MD: −1.03%; CI: −13.02, 10.95; p value = 0.87 (Chi2  =  0.18, df = 1, and p value  =  0.67). Hughston clinic questionnaire scores were not significantly different between OKC and CKC exercise patients: MD: −1.29% (−12.02, 9.43); p value = 0.81 (Chi2  =  0.01, df = 1, and p value = 0.93). Conclusions. While OKC and CKC may be beneficial during ACL surgical rehabilitation, there is insufficient evidence to suggest that either one is superior to the other.

scholarly journals Effects of Distally Fixated Versus Nondistally Fixated Leg Extensor Resistance Training on Knee Pain in the Early Period After Anterior Cruciate Ligament Reconstruction

2002 ◽  
Vol 82 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Matthew C Morrissey ◽  
Wendy I Drechsler ◽  
Dylan Morrissey ◽  
Philippa R Knight ◽  
Paul W Armstrong ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Resistance Training ◽  
Acl Reconstruction ◽  
Knee Pain ◽  
Cruciate Ligament ◽  
Early Period ◽  
Kinetic Chain ◽  
Reconstruction Surgery ◽  
Open Kinetic Chain ◽  
Anterior Cruciate

Abstract Background and Purpose. Nondistally fixated (ie, what is often referred to as “open kinetic chain” [OKC]) knee extensor resistance training appears to have lost favor for some forms of rehabilitation due partly to concerns that this exercise will irritate the extensor mechanism. In this randomized, single-blind clinical trial, nondistally fixated versus distally fixated (ie, often called “closed kinetic chain” [CKC]) leg extensor training were compared for their effects on knee pain. Subjects. Forty-three patients recovering from anterior cruciate ligament (ACL) reconstruction surgery (34 male, 9 female; mean age=29 years, SD=7.9, range=16–54). Methods. Knee pain was measured at 2 and 6 weeks after ACL reconstruction surgery using visual analog scales in a self-assessment questionnaire and during maximal isometric contractions of the knee extensors. Between test sessions, subjects trained 3 times per week using either OKC or CKC resistance of their knee and hip extensors as part of their physical therapy. Results. No differences in knee pain were found between the treatment groups. Discussion and Conclusion. Open kinetic chain and CKC leg extensor training in the early period after ACL reconstruction surgery do not differ in their immediate effects on anterior knee pain. Based on these findings, further studies are needed using different exercise dosages and patient groups.

Examining the Relationship Between a Neuromuscular Control Baseline Battery for Sport-Related Concussion and Anterior Cruciate Ligament Injury Risk

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S21.2-S22
Author(s):  
Ryan Moran
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Ligament Injury ◽  
Jump Landing ◽  
Eyes Closed ◽  
Eyes Open ◽  
Anterior Cruciate ◽  
The Relationship

ObjectiveTo examine the relationship between the m-CTSIB and Landing Error Scoring System in a sample of collegiate female athletes.BackgroundRecent literature has linked concussion and neuromuscular deficits in the lower extremity after injury. Neuromuscular control is frequently assessed using balance measures for concussion, but also dynamically to identify anterior cruciate ligament injury (ACL) risk via jump-landing movement screening.Design/MethodsThirty-nine healthy, collegiate female soccer (n = 22) and volleyball (n = 17) athletes completed the modified-Clinical Test of Sensory Interaction of Balance (m-CTSIB) and the Landing Error Scoring System (LESS). Measures consisted of total m-CTSIB sway index scores on individual conditions (firm surface eyes open [condition 1] and eyes closed [2], foam surface eyes open [3] and eyes closed [4]), m-CTSIB overall score, and total LESS errors. LESS scores were also categorized into a low (0–4 errors) and high (5 + errors) risk to determine if athletes with worse neuromuscular control on the LESS has worse balance on the m-CTSIB. A Spearman's rank-order correlation was conducted to determine the strength of the relationship between LESS and m-CTSIB performance. A series of Mann-Whitney U test were performed to determine differences between low and high LESS performance on m-CTSIB performance.ResultsThere was a weak, negative correlation between LESS and m-CTSIB performance (rs(37) = −0.153, p = 0.35). Further, there were no differences between the low and high risk LESS groups on sway index scores on conditions 1 (U = 158.5, p = 0.39), 2 (U = 156.0, p = 0.36), 3 (U = 165.5, p = 0.51), or 4 (U = 128.5, p = 0.08), as well as overall m-CTSIB scores (U = 150.5, p = 0.28).ConclusionsThere appears to be a lack of relationship between the LESS and m-CTSIB tests, revealing the independence of static and dynamic lower extremity neuromuscular function. Athletes who may be more at risk for ACL injury due to abnormal jump-landing biomechanics, do not differ from low-risk athletes on baseline balance assessment.

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