Sagittal Plane Knee Translation and Electromyographic Activity during Closed and Open Kinetic Chain Exercises in Anterior Cruciate Ligament-Deficient Patients and Control Subjects

2001 ◽  
Vol 29 (1) ◽  
pp. 72-82 ◽  
Author(s):  
Joanna Kvist ◽  
Jan Gillquist
2002 ◽  
Vol 82 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Matthew C Morrissey ◽  
Wendy I Drechsler ◽  
Dylan Morrissey ◽  
Philippa R Knight ◽  
Paul W Armstrong ◽  
...  

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.


Author(s):  
Carla van Usen ◽  
Barbara Pumberger

Background: Anterior cruciate ligament (ACL) injuries are common. A goal of rehabilitation is to restore functional capacity. Currently, there are contrary opinions regarding the effectiveness of using either closed or open kinetic chain exercises (CKC, OKC) only, or a combination of both, following ACL injury, to obtain the most effective outcome. The debate also reflects the approach which places the least force on the ACL itself. Objective: To identify the evidence of effectiveness of closed versus open kinetic chain exercises, or a combination of both, in anterior cruciate ligament rehabilitation. Methods: A systematic review was undertaken of experimental studies published since 1990. Included studies were on humans with ACL injury. The ACL ligament could be healthy, ruptured, deficient or reconstructed. Studies on animals and cadavers were excluded. The methodological quality of included studies was appraised with the PEDro tool. Studies were graded according to hierarchy level, methodological quality, statistical significance, effect size, and clinical relevance. Recommendations were made on the strength of the body of evidence. The outcome measure of interest was force on the ACL during exercise. Results: 23 eligible studies were included. The majority of studies reflected lower level experimental designs with moderate methodological quality. Three studies showed a significant difference in ACL force comparing CKC and OKC exercises, 11 demonstrated trends towards significant differences in outcome and nine showed no significant differences. Conclusion: There is moderate evidence to recommend CKC exercises or a combination of CKC and OKC exercises, rather than OKC exercises alone, for ACL rehabilitation when considering forces on the ACL.


Author(s):  
Morgan Belloir ◽  
Jean Mazeas ◽  
Maude Traullé ◽  
Amaury Vandebrouck ◽  
Pascal Duffiet ◽  
...  

Rehabilitation following anterior cruciate ligament reconstruction with hamstring graft allows the patient to regain his functional capacities and to support him in the resumption of sports activities. Rehabilitation also aims to minimize the risk of recurrence, which is why it ensures that the patient's muscular capacities develop properly until they return to sport. Isokinetics helps strengthen and assess the strength of muscle groups in the thigh, but controversy exists as to its use by resistance to the open kinetic chain knee extension that would cause the transplant to distend. The objective of this study is to determine the influence of isokinetic muscle strengthening on the possible laxity of the anterior cruciate ligament and to be able to determine risk factors. The study relates to a population having benefited from anterior cruciate ligament reconstruction with hamstring graft from 3 to 6 months after surgery. Two groups are differentiated, one group exposed to isokinetism during rehabilitation, the other group, named unexposed, undergoes rehabilitation without the use of isokinetism. An anterior knee laxity test is performed 6 months postoperatively using the GNRB® machine for all subjects according to the same protocol. The test results were statistically analyzed to determine a relative risk of transplant distension for each group in the study. Comparison of the results of each group by univariate analysis did not reveal any significant result. Multivariate analysis showed interactions in the two strata of the study. It was argued that the use of isokinetics seems to have no effect on the risk of developing distension for the majority of subjects in the exposed group. A tendency towards transplant protection was perceived for each variable except the age under 25 years (RRa = 1.07). The use of isokinetics does not appear to be a cause of transplant distension in patients undergoing an anterior cruciate ligament reconstruction when this method is introduced 3 months postoperatively.


2020 ◽  
Vol 8 (5) ◽  
pp. 232596712091905
Author(s):  
Shuang Ren ◽  
Huijuan Shi ◽  
Yuanyuan Yu ◽  
Zixuan Liang ◽  
Yanfang Jiang ◽  
...  

Background: Patients with anterior cruciate ligament–deficient (ACLD) knees with medial meniscal posterior horn tears (MMPHTs) have been reported to demonstrate a combined stiffening and pivot-shift gait pattern compared with healthy controls. Movement asymmetries are implicated in the development and progression of osteoarthritis. Purpose: To investigate the knee kinematics and kinetic asymmetries in ACLD patients with (ACLD + MMPHT group) and without (ACLD group) MMPHTs while walking on level ground. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 15 patients with isolated unilateral ACL ruptures, 10 with unilateral ACL ruptures and MMPHTs, and 22 healthy controls underwent gait testing between January 2014 and December 2016. Between-leg differences (BLDs) in knee kinematics and kinetics were compared among participants in all groups. Results: The ACLD + MMPHT group demonstrated significantly greater BLDs in knee moments in the sagittal plane during the loading response phase than the ACLD and control groups. Compared with the control group, the ACLD and ACLD + MMPHT groups demonstrated significantly greater BLDs in knee angles in the sagittal plane during the midstance and terminal stance phases. Compared with the control group, significantly greater BLDs in knee rotation moments were found throughout the stance phase in both the ACLD and the ACLD + MMPHT groups. BLDs in lateral ground-reaction forces (GRFs) in the ACLD + MMPHT and ACLD groups were both significantly greater than the control group during the loading response phase. BLDs in anterior GRFs in the ACLD + MMPHT and ACLD groups were both significantly greater than the control group during the loading response phase. Only the ACLD + MMPHT group demonstrated greater BLDs in vertical GRFs than the control group during the loading response phase, while no significant differences were observed between the ACLD and control groups. Conclusion: The ACLD + MMPHT group demonstrated significantly more knee flexion moment asymmetries than the ACLD and control groups during the loading response phase. Both the ACLD + MMPHT and the ACLD groups demonstrated significant knee angle and moment asymmetries in the sagittal plane during the terminal stance phase than the control group. Both the ACLD + MMPHT and the ACLD groups demonstrated knee rotation moment asymmetries during the midstance and terminal stance phases compared with the control group. A rehabilitation program for ACLD patients both with and without MMPHTs should take into consideration these asymmetric gait patterns.


2013 ◽  
Vol 41 (4) ◽  
pp. 788-794 ◽  
Author(s):  
Thiago Yukio Fukuda ◽  
Deborah Fingerhut ◽  
Viviane Coimbra Moreira ◽  
Paula Maria Ferreira Camarini ◽  
Nathalia Folco Scodeller ◽  
...  

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