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 Evaluation of Physical Therapy Effectiveness after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 2 (85) ◽  
Author(s):  
Kęstutis Radžiūnas ◽  
Vytenis Trumpickas ◽  
Jonas Poderys
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Therapy Group ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Flexor Muscle ◽  
Therapy Program ◽  
Physical Therapy Program ◽  
Anterior Cruciate

Research background and hypothesis. The aim of physical therapy after sports trauma is to help patients to restore physical activity as it was before injury. The participants who applied for intensive physical therapy after anterior cruciate ligament reconstructive surgery will achieve better leg muscle strength results.Research aim was to compare the effectiveness of intensive and traditional rehabilitation of the knee extensor and flexor muscle strength after the surgery for patients after anterior cruciate ligament reconstruction.Research methods. The method that we used was “Biodex Medical System 3 PRO” for the knee muscle strength. A total of 30 patients were enrolled in this study. The subjects were divided into two groups. The muscle strength was measured while leg was flexed and extended at the knee joint.Research results. The research results showed that participants who received intensive physical therapy program developed better muscle strength than in standard physical therapy group. Participant’s leg muscles recovered faster in intensive physical therapy group than in standard physical therapy group.Discussion and conclusions. The participants who received physical therapy before surgery, electrostimulation and intensive physical therapy program after surgery, achieved higher levels of knee extensor and flexor muscle strength after anterior cruciate ligament reconstructive surgery than those patients undergoing a traditional physical therapy program only after surgery.Keywords: anterior cruciate ligament, intensive physical therapy, muscle strength.

scholarly journals Running Biomechanics Before Injury and 1 Year After Anterior Cruciate Ligament Reconstruction in Division I Collegiate Athletes

2021 ◽  
pp. 036354652110266
Author(s):  
Keith A. Knurr ◽  
Stephanie A. Kliethermes ◽  
Mikel R. Stiffler-Joachim ◽  
Daniel G. Cobian ◽  
Geoffrey S. Baer ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Collegiate Athletes ◽  
Treadmill Running ◽  
Division I ◽  
P Values ◽  
Peak Knee ◽  
Anterior Cruciate ◽  
Running Biomechanics

Background: Preinjury running biomechanics are an ideal comparator for quantifying recovery after anterior cruciate ligament (ACL) reconstruction (ACLR), allowing for assessments within the surgical and nonsurgical limbs. However, availability of preinjury running biomechanics is rare and has been reported in case studies only. Purpose/Hypothesis: The purpose of this study was to determine if running biomechanics return to preinjury levels within the first year after ACLR among collegiate athletes. We hypothesized that (1) surgical knee biomechanics would be significantly reduced shortly after ACLR and would not return to preinjury levels by 12 months and (2) nonsurgical limb mechanics would change significantly from preinjury. Study Design: Cohort study; Level of evidence, 2. Methods: Thirteen Division I collegiate athletes were identified between 2015 and 2020 (6 female; mean ± SD age, 20.7 ± 1.3 years old) who had whole body kinematics and ground-reaction forces recorded during treadmill running (3.7 ± 0.6 m/s) before sustaining an ACL injury. Running analyses were repeated at 4, 6, 8, and 12 months (4M, 6M, 8M, 12M) after ACLR. Linear mixed effects models were used to assess differences in running biomechanics between post-ACLR time points and preinjury within each limb, reported as Tukey-adjusted P values. Results: When compared with preinjury, the surgical limb displayed significant deficits at all postoperative assessments ( P values <.01; values reported as least squares mean difference [SE]): peak knee flexion angle (4M, 13.2° [1.4°]; 6M, 9.9° [1.4°]; 8M, 9.8° [1.4°]; 12M, 9.0° [1.5°]), peak knee extensor moment (N·m/kg; 4M, 1.32 [0.13]; 6M, 1.04 [0.13]; 8M, 1.04 [0.13]; 12M, 0.87 [0.15]; 38%-57% deficit), and rate of knee extensor moment (N·m/kg/s; 4M, 22.7 [2.4]; 6M, 17.9 [2.3]; 8M, 17.5 [2.4]; 12M, 16.1 [2.6]; 33%-46% deficit). No changes for these variables from preinjury ( P values >.88) were identified in the nonsurgical limb. Conclusion: After ACLR, surgical limb knee running biomechanics were not restored to the preinjury state by 12M, while nonsurgical limb mechanics remained unchanged as compared with preinjury. Collegiate athletes after ACLR demonstrate substantial deficits in running mechanics as compared with preinjury that persist beyond the typical return-to-sport time frame. The nonsurgical knee appears to be a valid reference for recovery of the surgical knee mechanics during running, owing to the lack of change within the nonsurgical limb.

Assessing Physical Activity After ACL Injury: Moving Beyond Return to Sport

2021 ◽  
pp. 194173812110253
Author(s):  
Christopher Kuenze ◽  
Katherine Collins ◽  
Karin Allor Pfeiffer ◽  
Caroline Lisee
Keyword(s):  
Physical Activity ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Young Patients ◽  
Return To Sport ◽  
Acl Injury ◽  
Noncommunicable Diseases ◽  
Successful Recovery ◽  
Patient Reported ◽  
Anterior Cruciate

Context: Return to sport is widely utilized by sports medicine researchers and clinicians as a primary outcome of interest for successful recovery when working with young patients who have undergone anterior cruciate ligament (ACL) reconstruction (ACLR). While return-to-sport outcomes are effective at tracking progress post-ACLR, they are limited because they do not necessarily capture physical activity (PA) engagement, which is important to maintain knee joint health and reduce the risk of noncommunicable diseases. Therefore, there is a critical need (1) to describe current PA participation and measurement recommendations; (2) to appraise common PA measurement approaches, including patient-reported outcomes and device-based methodologies; and (3) to provide clinical recommendations for future evaluation. Evidence Acquisition: Reports of patient-reported or device-based PA in patients with ACL injury were acquired and summarized based on a PubMed search (2000 through July 2020). Search terms included physical activity OR activity AND anterior cruciate ligament OR ACL. Study Design: Clinical review. Level of Evidence: Level 5. Results: We highlight that (1) individuals with ACLR are 2.36 times less likely to meet the US Department of Health and Human Services PA recommendations even when reporting successful return to sport, (2) common patient-reported PA assessments have significant limitations in the data that can be derived, and (3) alternative patient-reported and device-based assessments may provide improved assessment of PA in this patient population. Conclusion: Clinicians and researchers have relied on return to sport status or self-reported PA participation via surveys. These approaches are not consistent with current recommendations for PA assessment and do not allow for comparison with contemporary PA recommendations or guidelines. Return to sport, patient-reported outcome measures, and device-based assessment approaches should be used in complementary manners to comprehensively assess PA participation after ACLR. However, appropriate techniques should be used when assessing PA in adult and adolescent populations.

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

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