Objectives: The purpose of this study was to evaluate the intrarater reliability of selected clinical outcome measures in patients having ACL reconstruction. Background: Several investigations have reported the reliability of isokinetic testing and knee ligament arthrometry. Fewer studies have examined the reliability of lower extremity functional tests, with most of these studies evaluating normal subjects. Methods and Measures: Fifteen physically active males with unilateral ACL-reconstructed knees were evaluated with the KT-1000, Biodex isokinetic dynamometer, and 3 functional hop tests on 5 occasions. Results: lntraclass correlation coefficients (ICCs) revealed good to high intrarater reliability (ICC >0.80) of the functional hop tests and isokinetic peak torque values. KG were higher for the involved limb than the uninvolved limb using the scores from the KT-1000 Manual Maximum Test. Conclusions: The outcome measures examined in this investigation have been shown to be reliable in patients with ACL reconstructions, and support previous investigations in nonimpaired populations. Further research is needed to examine the validity of these postoperative outcome measures in patients with ACL reconstructions. ) . . -Greater demands are being placed on sports physical therapists to improve the measurement and documentation of clinical outcomes following rehabilitation programs of injured athletes. Success is often determined by a return to the same or better level of functional performance than before the injury. The final phase in the management of an injured athlete requires the timely and safe transition from the rehabilitation environment to actual competition. Although physical characteristics such as range of motion, girth, isokinetic strength, and static ligamentous laxity tests provide useful information about an athlete's postinjury or postoperative Isokinetic testing, commonly used by sports medicine clinicians to assess strength and muscle performance, has been determined to be safe17 and reliableS.19.40.P9.S8.~~41~45~~52P58~74~~ with reported intraclass coefficients (ICCs) ranging from 0.72 to 0.99.Many functional tests have been reported to identi-Q, assess, and evaluate knee stability and function following ACL injury or reconstruction. Some of the more commonly used functional tests reported in the literature include the single-leg hop(s), figure 8 run, shuttle run, vertical jump, joint position reproduction, and a crossover cutting maneu~er.~J~v~~.~2. M.75.76 These research investigations provided useful information regarding assessment following ACL injury or reconstruction, but the investigators declined to report on the reliability of the functional tests examined. A recent investigation by Risberg and Ekeland62 examined 6 functional tests performed by patients after ACL reconstruction, but did not report on the tests' reliability. Lephart et a14S.M suggested that the best assessment of functional capacity in athletes with ACL insufficiency is achieved through the use of 3 "functional perfor...

Knee osteoarthritis (OA), which affects over 27 million Americans, decreases the individual's quality of life through decreasing mobility, deconditioning, reducing functional ability, and increasing knee pain. The present aim was to assess whether such patients engaging in exercise prior to surgery ("prehabilitation"; preoperative exercise intervention) rate higher quality of life 3 mo. after their surgery compared with ratings by patients who did not engage in prehabilitation. Standard populations consist of OA patients that do not participate in any preoperative exercise programs, such as a prehabilitation exercise intervention. 18 knee osteoarthritis patients were randomly assigned to a control or a prehabilitation group. The latter group participated in an exercise intervention three times per week, once at home and twice at the physical therapy lab, for 8 wk. prior to their surgery. The control group participated in their usual preoperative care prescribed by the physician for all patients. Eight health-related quality of life domains were assessed at 3 mo. post surgery. These preliminary findings suggest efficacy of prehabilitation in facilitating quality of life of total knee arthroplasty (TKA) patients 3 mo. after surgery.

No abstract

Side-to-side differences in lower extremity biomechanics may be predictive of increased risk of lower extremity injuries in athletes. The purpose of this report is to provide field testing methodology for tests designed to isolate lower extremity asymmetry and to demonstrate the potential for these tests to provide reliable measures. Six athletes (3 females, 3 males), were tested on two consecutive days for activities incorporated into a replicated NFL combine setting. VHP and jump height were measured on a portable force platform as athletes performed maximum effort hops for 10 seconds. The MAT test incorporates two 90° single leg cuts during the trial and was measured as total time for completion. Intraclass correlations (within ICC [3,k], between: ICC [3,1]) were calculated. The VHP test had good to excellent within session reliability for peak power of both the right (ICC = 0.942) and left (ICC = 0.895) sides. Jump height showed excellent within session reliability for both the right (ICC = 0.963) and left (ICC = 0.940) sides. The between session reliability for peak power between jumps was good for the right (ICC = 0.748) and left (ICC = 0.834) sides. Jump height showed good to excellent between session reliability on the right (ICC = 0.794) and left (ICC = 0.909) sides. The MAT test also showed good reliability between days (ICC = 0.825). The results indicate that the VHP test provides reliable assessment of both within and between session jump height and power production. The MAT test also provides good reliability between testing days. Both the VHP test and the MAT test may be useful for clinicians to identify the presence of lower limb asymmetry and potential injury risk factors in athletic populations.

We present a clinical commentary of existing evidence regarding popliteus musculotendinous complex anatomy, biomechanics, muscle activation, and kinesthesia as they relate to functional knee joint rehabilitation. The popliteus appears to act as a dynamic guidance system for monitoring and controlling subtle transverse-and frontal-plane knee joint movements, controlling anterior-posterior lateral meniscus movement, unlocking and internally rotating the knee joint (tibia) during flexion initiation, assisting with 3-dimensional dynamic lower extremity postural stability during single-leg stance, preventing forward femoral dislocation on the tibia during flexed-knee stance, and providing for postural equilibrium adjustments during standing. These functions may be most important during mid-range knee flexion when capsuloligamentous structures are unable to function optimally. Because the popliteus musculotendinous complex has attachments that approximate the borders of both collateral ligaments, it has the potential for providing instantaneous 3-dimensional kinesthetic feedback of both medial and lateral tibiofemoral joint compartment function. Enhanced popliteus function as a kinesthetic knee joint monitor acting in synergy with dynamic hip muscular control of femoral internal rotation and adduction, and ankle subtalar muscular control of tibial abduction-external rotation or adductioninternal rotation, may help to prevent athletic knee joint injuries and facilitate recovery during rehabilitation by assisting the primary sagittal plane dynamic knee joint stabilization provided by the quadriceps femoris, hamstrings, and gastrocnemius. J Orthop Sports Phys Ther 2005;35:165-179.