scholarly journals Asymmetry of muscle strength values during the basic period of rehabilitation after anterior cruciate ligament reconstruction in athletes

2021 ◽  
pp. 26-32
Author(s):  
О.V. Beziazychna ◽  
V.О. Litovchenko
Keyword(s):  
Muscle Strength ◽  
Cruciate Ligament ◽  
Rectus Femoris ◽  
Mean Amplitude ◽  
Rehabilitation Program ◽  
Asymmetry Index ◽  
Physical Rehabilitation ◽  
Basic Period ◽  
The Mean ◽  
Anterior Cruciate

Objective: to specify the features of muscle strength imbalance values as the criteria defining intensity and progress of rehabilitation after anterior cruciate ligament (ACL) reconstruction in athletes. The study involved 46 athletes having ACL injury. All the injured were young people under 44 years of age according to the current WHO classification. The control group, or experimental group consisted of 23 patients, and there were 25 patient s in the main one. Physical rehabilitation program for the patients of the CG and MG included therapeutic exercises, massage, and electrical myostimulation. Physical rehabilitation program for the MG patients was aimed at the priority recovery of tone, strength and mass of hamstrings. The article evaluates the effect of the developed physical rehabilitation program on the relation of strength values of the injured and intact limbs during the basic period of rehabilitation. The CG patients showed positive changes only according to EMG (asymmetry index of the mean amplitude of the rectus femoris and vastus medialis (р <0,05), and the MG patients significantly restored the balance between muscle strength values according to dynamometry results (moment of hip flexors and extensors strength, р<0,01; asymmetry index of hip flexors and extensors strength, р<0,05), and EMG (asymmetry index of the mean amplitude of the rectus femoris and vastus medialis, р<0,05). The study found that physical therapy program which additionally included electrical myostimulation and special exercises for hamstrings has significant effect on the relation of strength values of the injured and intact limbs during the basic period of rehabilitation.

scholarly journals Impact of intensive and traditional rehabilitation on quadriceps strength after anterior cruciate ligament reconstructive surgery

Medicina ◽  
2006 ◽  
Vol 43 (1) ◽  
pp. 51
Author(s):  
Vytautas Streckis ◽  
Albertas Skurvydas ◽  
Pavelas Zachovajevas ◽  
Rimtautas Gudas ◽  
Justė Lukšaitė ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Reconstructive Surgery ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Rehabilitation Program ◽  
Anterior Cruciate ◽  
Knee Extensor Muscle Strength ◽  
Intensive Rehabilitation

After knee anterior cruciate ligament reconstructive surgery, the recovery of the former level of physical activity takes from 3 to 12 months. Such a wide range of recovery period of physical activity suggests that rehabilitation in most cases is not optimal. According to the majority of authors, after the surgery, a patient can resume intensive physical activity, when the difference in muscle strength between the operated lower extremity and another extremity is not greater than 10–15%. The aim of this study was to compare the impact of intensive and normal rehabilitations on the recovery of knee extensor muscle strength after the surgery. Material and methods. A total of 40 patients were enrolled in this study. The subjects were divided into two groups. Both groups were engaged in physical activity. The mean age of patients (16 men and 4 women) in the first group at the time of surgery was 26.4±8.1 years, mean height – 179.8±8.5 cm, and mean weight – 76.0±14.0 kg. An intensive rehabilitation was applied for the first group of the patients studied. The second group consisted of 13 men and 7 women who were engaged in moderate physical activity. Their mean age at the time of surgery was 27.0±9.3 years, mean height – 173.2±6.2 cm, and mean weight – 71.0±9.0 kg. A traditional rehabilitation was applied to this group. Muscle strength was measured in the patients of both groups studied approximately 5.2 months following surgery using the Biodex isokinetic dynamometer. Results. The patients undergoing an intensive rehabilitation achieved higher levels of knee extensor muscle strength than those patients undergoing a traditional rehabilitation program. Applying an aggressive rehabilitation program, knee extensor muscles recover more quickly than using a traditional rehabilitation program. The comparison of intensive and traditional rehabilitation programs applied to the operated and unoperated lower extremities has shown that the indexes of knee extensor muscle strength differed by 11.51– 12.74%. Applying a traditional rehabilitation, a 23.68–49.42% difference in knee flexor muscle strength between operated and unoperated extremities was noted. Conclusions. The effect of intensive rehabilitation aimed at strength recovery of knee extensor muscles after anterior cruciate ligament reconstructive surgery is greater than after ordinary rehabilitation.

scholarly journals Effect of exogenous growth hormone and exercise on lean mass and muscle function in children with burns

2003 ◽  
Vol 94 (6) ◽  
pp. 2273-2281 ◽  
Author(s):  
Oscar E. Suman ◽  
Steve J. Thomas ◽  
Judy P. Wilkins ◽  
Ronald P. Mlcak ◽  
David N. Herndon
Keyword(s):  
Growth Hormone ◽  
Muscle Strength ◽  
Lean Body Mass ◽  
Body Mass ◽  
Recombinant Human Growth Hormone ◽  
Rehabilitation Program ◽  
Physical Rehabilitation ◽  
Percent Change ◽  
Home Based ◽  
The Mean

We tested the hypothesis that the administration of recombinant human growth hormone (rHGH) and exercise would increase lean body mass (LBM) and muscle strength in burned children to a greater extent than rHGH or exercise separately. Children, ages 7–17 yr, with >40% body surface area burned, were randomized into groups. One group (GHEX, n = 10) participated in a 12-wk in-hospital physical rehabilitation program supplemented with an exercise program and received 0.05 mg · kg−1· day−1of rHGH. A second exercising group (SALEX, n = 13) received saline. A third group (GH, n = 10) received a similar dose of rHGH as GHEX and participated in a 12-wk, home-based physical rehabilitation program without exercise. The fourth group (Saline, n = 11) received saline and participated in a 12-wk, home-based physical rehabilitation program without exercise. The mean (±SE) percent change in lean body mass after 12 wk was not significantly different between GHEX (9.0 ± 2.1%), SALEX (5.4 ± 1.6%), and GH (5.8 ± 1.8%) groups ( P = 0.33). However, the mean percent change in muscle strength was significantly greater in the GHEX (36.2 ± 5.4%) and SALEX (42.6 ± 10.0%) groups than in the GH (−7.4 ± 4.7%) or Saline (6.7 ± 4.4%) groups ( P = 0.008). In summary, rHGH GHEX, SALEX, and GH alone produced similar improvements in LBM. However, muscle strength was only increased via exercise.

scholarly journals Autologous conditioned plasma in anterior cruciate ligament reconstruction with hamstrings – short term clinical results

2012 ◽  
Vol 18 (3) ◽  
pp. 111-115
Author(s):  
O.M. Russu ◽  
I. Gergely ◽  
Ancuța Zazgyva ◽  
I. Moldovan ◽  
T.S. Pop
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Clinical Results ◽  
Interference Screw ◽  
Lysholm Score ◽  
Cruciate Ligament Reconstruction ◽  
The Mean ◽  
Anterior Cruciate

Abstract Evaluating the early clinical results of anterior cruciate ligament reconstruction using hamstrings autograft, with interference screw on the tibial side (biocomposite interference screw, ConMed-Linvatec) and continuous closed loop fixation on the femoral side (XO-Button, ConMed-Linvatec), with and without intra-articular injection of autologous conditioned plasma (ACP). Our study included 21 patients with chronic anterior cruciate ligament (ACL) ruptures for whom we performed ACL reconstruction with a hamstrings autograft. The mean age was 34 years (range, 25 to 42), 16 patients were men and 5 were women. In 10 cases we performed an intraarticular infiltration of ACP at the end of the surgical intervention. Final evaluation was performed at the end of the 6th postoperative month using the Lysholm scoring system, Tegner activity scale and objective assessment with the RolimeterTM 50A. The Lysholm score was excellent in all cases at 6 months postoperatively, with a mean Lysholm score of 90 for patients without ACP and 91.09 for patients that received ACP; the mean Tegner activity score was also similar pre- and postoperatively for the two groups (from 3.5 and 3.63 for the group without ACP and the group with ACP to 5.6 and 5.72 respectively). Joint laxity measurement was similar for both groups. We found no graft ruptures. We found similar results after ACL reconstruction with and without intra-articular injection of PRP, but further studies are necessary to determine the exact role of these substances in speeding up the recovery process in these cases.

Twenty-Year Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Prospectively Collected Data

2021 ◽  
pp. 036354652110273
Author(s):  
Joshua S. Everhart ◽  
Sercan Yalcin ◽  
Kurt P. Spindler
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Increased Risk ◽  
Patient Reported ◽  
The Mean ◽  
Anterior Cruciate

Background: Several long-term (≥20 years) follow-up studies after anterior cruciate ligament (ACL) reconstruction have been published in recent years, allowing for a systematic evaluation of outcomes. Purpose: To summarize outcomes at ≥20 years after ACL reconstruction and identify patient and surgical factors that affect these results. Study Design: Systematic review; Level of evidence, 4. Methods: Prospective studies of primary ACL reconstructions with hamstring or bone–patellar tendon—bone (BTB) autograft via an arthroscopic or a mini-open technique and with a mean follow-up of ≥20 years were identified. When possible, the mean scores for each outcome measure were calculated. Factors identified in individual studies as predictive of outcomes were described. Results: Five studies met the inclusion and exclusion criteria with a total of 2012 patients. The pooled mean follow-up for patient-reported outcome measures was 44.2% (range, 29.6%-92.7%) and in-person evaluation was 33.2% (range, 29.6%-48.9%). Four studies (n = 584) reported graft tears at a mean rate of 11.8% (range, 2%-18.5%) and 4 studies (n = 773) reported a contralateral ACL injury rate of 12.2% (range, 5.8%-30%). Repeat non-ACL arthroscopic surgery (4 studies; n = 177) to the ipsilateral knee occurred in 10.4% (range, 9.5%-18.3%) and knee arthroplasty (1 study; n = 217) in 5%. The pooled mean of the International Knee Documentation Committee subjective knee function (IKDC) score was 79.1 (SD, 21.8 [3 studies; n = 644]). In 2 studies (n?= 221), 57.5% of patients continued to participate in strenuous activities. The IKDC-objective score was normal or nearly normal in 82.3% (n = 496; 3 studies), with low rates of clinically significant residual laxity. Moderate-severe radiographic osteoarthritis (OA) (IKDC grade C or D) was present in 25.9% of patients (n = 605; 3 studies). Medial meniscectomy is associated with increased risk of radiographic OA. Radiographic OA severity is associated with worse patient-reported knee function, but the association with knee pain is unclear. Conclusion: Currently available prospective evidence for ACL reconstruction with hamstring or BTB autograft provides several insights into outcomes at 20 years. The rates of follow-up at 20 years range from 30% to 93%. IKDC-objective scores were normal or nearly normal in 82% and the mean IKDC-subjective score was 79 points.

scholarly journals Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0027
Author(s):  
Osman Çiloğlu ◽  
Hakan Çiçek ◽  
Ahmet Yılmaz ◽  
Metin Özalay ◽  
Gökhan Söker ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Surgical Technique ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Tunnel Widening ◽  
Isokinetic Muscle Strength ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Group 1

Objectives: We investigated the effects anatomic or nonanatomic femoral tunnel positions and tunnel fixation methods obtained using two different surgery methods on tunnel widening and clinical results in anterior cruciate ligament (ACL) reconstructions. Methods: Patients with isolated anterior cruciate ligament rupture are included to study who don’t have intra-and extra-articular additional pathology of the knee, without previously a history of operations of both knees. 2 groups were created. Group 1 Aperfix implant were used which can be able to perform non anatomical femoral tunnel and intra tunnel fixation with transtibial technique. In Group 2 Endobutton CL implant were used which can make fixation from outside the cortex with anatomic femoral tunnel in use of anteromedial portal techniques. 27 patients (average age 29,33, range 18 to 55 years) in group 1 and 27 patients (average age 27,51, range 16 to 45 years) in group 2 totally 54 patients were performed surgery. All patients were assessed using the IKDC (International knee documentation committee), Tegner Activity Scala and Lysholm II Functional Scores. Muscle strength measurements in both groups compared to intact knee was measured with an isokinetic dynamometer Biodex System 3 Pro. The location of the femoral tunnel aperture and tunnel widening were imaged with 3D reconstructive computed tomography. All measurements were performed using the same software application by the same radiologist. Results: The two groups were similar with respect to age and sex distribution, operated side, the size of the tunnel created, and follow-up period (p>0.05). After surgery in both groups, the clinical scores showed significant improvement compared to preoperative (p=0,0001). However, postoperative clinical outcomes in the two groups did not show a difference significantly (p>0,005). Isokinetic muscle strength study showed significant differences between the two groups (p=0,0001). Location of femoral tunnel aperture on the medial wall of the lateral femoral condyle showed a significant differences in the two groups (p=0,0001). The expansion of proximal and distal femoral tunnel in two groups showed significant differences (p=0,0001). There was relationship between distal femoral tunnel widening and location of femoral tunnel aperture. Conclusion: Although there is no statistically significant difference between the two groups clinically, difference noticed in terms of isokinetic muscle strength may be due to differences in the degree of shift as a result of multiple loading depending on the biomechanical properties of materials. We thought that the difference seen in the widening of tunnel in the proximal or distal may be due to, the technique of graft fixation, the distance between the fixation point and the joint, and to the location of the femoral tunnel aperture on medial wall of lateral condyle from anatomical or non anatomical region. There is no golden standard in neither surgical technique nor material of fixation. Proper theoretical knowledge and extensive clinical experience are important in the light of an accurate surgical technique applied. We thought that information we have reached in our study should be supported by biomechanical studies

Injury to the Anterior Cruciate Ligament during Alpine Skiing

2002 ◽  
Vol 30 (4) ◽  
pp. 537-540 ◽  
Author(s):  
Sharon L. Hame ◽  
Daniel A. Oakes ◽  
Keith L. Markolf
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Alpine Skiing ◽  
Full Extension ◽  
Flexion Extension ◽  
Fresh Frozen ◽  
Full Flexion ◽  
The Mean ◽  
Anterior Cruciate ◽  
Knee Flexion Position

Background The anterior cruciate ligament has been shown to be particularly susceptible to injury during alpine skiing. Tibial torque is an important injury mechanism, especially when applied to a fully extended or fully flexed knee. Purpose We wanted to record the forces generated in the anterior cruciate ligament with application of tibial torque to cadaveric knees in different positions. Study Design Controlled laboratory study. Methods Thirty-seven fresh-frozen cadaveric knees were instrumented with a tibial load cell that measured resultant force in the anterior cruciate ligament while internal and external tibial torques were applied to the tibia at full extension, 90° of flexion, full flexion, and forced hyperflexion. Results At each knee flexion position, mean force generated by 10 N·m of internal tibial torque was significantly higher than the mean generated by 10 N·m of external tibial torque. Mean forces generated by tibial torque at 90° of flexion were relatively low. During flexion-extension without tibial torque applied mean forces were highest (193 N) when the knee was hyperflexed. Conclusions Application of internal tibial torque to a fully extended or fully flexed knee represents the most dangerous loading condition for injury from twisting falls during skiing. Clinical Relevance Understanding of the mechanisms of falls can be used to design better equipment and to better prevent or treat injury.

scholarly journals Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study

Joints ◽  
2018 ◽  
Vol 06 (01) ◽  
pp. 023-032 ◽  
Author(s):  
Federica Rosso ◽  
Davide Bonasia ◽  
Umberto Cottino ◽  
Simone Cambursano ◽  
Federico Dettoni ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Rehabilitation Program ◽  
Return To Play ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Objective Outcomes ◽  
Subjective Outcomes

Purpose To analyze the prognostic factors influencing subjective and objective outcomes and return to play (RTP) after anterior cruciate ligament reconstruction (ACL-R). Methods Primary ACL-Rs using a transtibial technique performed between 2008 and 2012 were included. Data regarding patients, surgery, sports, and rehabilitation, including an on-field rehabilitation (OFR) and duration of the rehabilitation program, were collected. The International Knee Documentation Committee (IKDC) subjective and objective evaluation forms, and the Knee Injury and Osteoarthritis Outcome Score and Lysholm questionnaires were used for the assessment of subjective and objective outcomes. The Subjective Patient Outcome for Return to Sports and ACL–return to sport after injury (RSI) scores were used for RTP evaluation. Several potential predictors of outcome were tested with a univariate analysis. All the variables with p < 0.1 were retested in a logistic regression model to evaluate their association with the outcomes. Results In total, 176 cases were included with an average follow-up of 44.1 months. Of the patients, 92.2% were rated as normal or nearly normal at the IKDC evaluation. In addition, 90.1% of the patients returned to sport, with 57.6% returning to the same preinjury level. Objective outcomes were negatively influenced by late rehabilitation (odds ratio [OR] = 2.75). Performing an OFR phase during the rehabilitation was associated with better subjective outcomes (OR = 2.71). Length of rehabilitation strongly influenced the RTP rate (OR = 13.16). Conversely, higher ACL-RSI score was inversely related to RTP. Objective IKDC score was inversely related to the ACL-RSI (OR = 0.31), whereas subjective score was correlated with both the total ACL-RSI score (OR = 0.15) and the level of activity (OR = 0.20). Conclusion This study confirmed the role of rehabilitation on subjective and objective outcomes and on RTP. Particularly, the complete adherence to a rehabilitation program, including an OFR phase, resulted in better subjective outcomes and higher RTP rate. The relationship between psychological factors, measured through the ACL-RSI score, and RTP was confirmed. Level of Evidence Level III, observational study without a control group.

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