A Stabilometric Technique for Evaluation of Functional Instability in Anterior Cruciate Ligament-Deficient Knee

Mizuta, Hiroshi; Shiraishi, Minoru; Kubota, Kenji; Kai, Koichi; Takagi, Katsumasa

doi:10.1097/00042752-199210000-00002

Cited by 24 publications

(25 citation statements)

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“…They concluded that stabilometry was a useful method for evaluating functional instability of the knee. 54 Tropp et al 84 reported that athletes who could not demonstrate postural balance within 2 standard deviations of normal had a significantly higher risk of lower extremity injury. Normal female subjects demonstrate greater single-limb postural stability than males on a stabilometer.…”

Section: Stage 1: Criteria For Progressionmentioning

confidence: 99%

Rehabilitation After Anterior Cruciate Ligament Reconstruction: Criteria-Based Progression Through the Return-to-Sport Phase

Myer¹,

Paterno²,

Ford³

et al. 2006

J Orthop Sports Phys Ther

421

401

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Rehabilitation following anterior cruciate ligament (ACL) reconstruction has undergone a relatively rapid and global evolution over the past 25 years. However, there is an absence of standardized, objective criteria to accurately assess an athlete's ability to progress through the end stages of rehabilitation and safe return to sport. Return-to-sport rehabilitation, progressed by quantitatively measured functional goals, may improve the athlete's integration back into sport participation. The purpose of the following clinical commentary is to introduce an example of a criteria-driven algorithm for progression through return-to-sport rehabilitation following ACL reconstruction. Our criteria-based protocol incorporates a dynamic assessment of baseline limb strength, patientreported outcomes, functional knee stability, bilateral limb symmetry with functional tasks, postural control, power, endurance, agility, and technique with sport-specific tasks. Although this algorithm has limitations, it serves as a foundation to expand future evidence-based evaluation and to foster critical investigation into the development of objective measures to accurately determine readiness to safely return to sport following injury.

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Section: Stage 1: Criteria For Progressionmentioning

confidence: 99%

Rehabilitation After Anterior Cruciate Ligament Reconstruction: Criteria-Based Progression Through the Return-to-Sport Phase

Myer¹,

Paterno²,

Ford³

et al. 2006

J Orthop Sports Phys Ther

421

401

View full text Add to dashboard Cite

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“…3 Many of the potential risk factors cannot be measured after ACL disruption, because the injury modifies the risk factors, [4][5][6][7][8][9][10][11] and bilateral asymmetry cannot always be assumed.…”

Section: Articlementioning

confidence: 99%

“…Controlling and measuring multiple variables creates considerable challenges, as variables have the potential to interact with one another, and many of these variables are poorly defined or difficult to obtain reliably. 3 Many of the potential risk factors cannot be measured after ACL disruption, because the injury modifies the risk factors, [4][5][6][7][8][9][10][11] and bilateral asymmetry cannot always be assumed. 12,13 Because of these limitations, large prospective studies are recommended to identify ACL injury risk factors.…”

Section: Articlementioning

confidence: 99%

Intratester and Intertester Reliability of Clinical Measures of Lower Extremity Anatomic Characteristics: Implications for Multicenter Studies

Shultz

Nguyen²,

Windley³

et al. 2006

Clinical Journal of Sport Medicine

106

137

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Abstract:Objective: To determine whether multiple examiners could be trained to measure lower extremity anatomic characteristics with acceptable reliability and precision, both within (intratester) and between (intertester) testers. We also determined whether testers trained 18 months apart could perform these measurements with good agreement. Setting: University's Applied Neuromechanics Research Laboratory. Participants: Sixteen, healthy participants (7 men, 9 women). Assessment of Risk Factors: Six investigators measured 12 anatomic characteristics on the right lower extremity in the Fall of 2004. Four testers underwent training immediately preceding the study, and measured subjects on 2 separate days to examine intratester reliability. Two testers trained 18 months before the study (Spring 2002) measured each subject on day 1 to examine the consistency of intertester reliability when testers are trained at different times. Main Outcome Measurements: Knee laxity, genu recurvatum, quadriceps angle, tibial torsion, tibiofemoral angle, hamstring extensibility, pelvic angle, navicular drop, femur length, tibial length, and hip anteversion. Results: With few exceptions, all testers consistently measured each variable between test days (intraclass correlation coefficient>=0.80). Intraclass correlation coefficient values were lower for intertester reliability (0.48 to 0.97), and improved from day 1 to day 2. Intertester reliability was similar when comparing testers trained 18 months before those trained immediately before the study. Absolute measurement error varied considerably across individual testers. Conclusions: Multiple investigators can be trained at different times to measure anatomic characteristics with good to excellent intratester reliability. Intratester reliability did not always ensure acceptable intertester reliability or measurement precision, suggesting more training (or more experience) may be required to achieve acceptable measurement reliability and precision between multiple testers.Keywords: lower extremity alignment | risk factor assessment | posture | measurement stability Article:Little is known about the factors that predispose an individual to anterior cruciate ligament (ACL) injury.1,2 In part, this is because of the myriad of factors that have been proposed to explain the risk of ACL injury. Controlling and measuring multiple variables creates considerable challenges, as variables have the potential to interact with one another, and many of these variables are poorly defined or difficult to obtain reliably.3 Many of the potential risk factors cannot be measured after ACL disruption, because the injury modifies the risk factors, [4][5][6][7][8][9][10][11] and bilateral asymmetry cannot always be assumed. 12,13Because of these limitations, large prospective studies are recommended to identify ACL injury risk factors.14-17 However, prospective studies present their own challenges, as a large cohort of subjects is needed to yield sufficient ACL injuries. Uhorchak et al 16 prospectively fol...

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“…14,16,35,43 In the past, stabilometry studies were performed on a static force plate with measurement of center of pressure displacement in the sagittal and coronal planes. More recently, dynamic mobile platforms that also measure center of pressure displacement in 2 dimensions have been developed.…”

mentioning

confidence: 99%

“…8,20,22,35,43,45 Assessment of change in postural stability and proprioceptive ability in these populations was quantified through the assessment of joint position sense, joint kinesthesia, and stabilometry, and has supported the role of postural stability training in the functional stability of the lower extremity following injury. 1,2,13,31,32,38,39 With respect to patients with mechanically stable knees following ACL reconstruction, proprioception and postural stability can improve over the first 9 to 12 months postoperatively as a result of rehabilitation focused on balance and proprioception.…”

mentioning

confidence: 99%

Neuromuscular Training Improves Single-Limb Stability in Young Female Athletes

Paterno

Myer

Ford

et al. 2004

J Orthop Sports Phys Ther

275

160

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Study Design: Controlled single-group pretest/posttest design. Objective: The purpose of this study was to determine if a 6-week neuromuscular training program designed to decrease the incidence of anterior cruciate ligament (ACL) injuries would improve single-limb postural stability in young female athletes. We hypothesized neuromuscular training would result in an improvement in postural stability, with the greatest improvement taking place in the medial-lateral direction. Background: Balance training has become a common component of programs designed to prevent ACL injury. Rehabilitation programs can improve postural stability following ACL injury and reconstruction; however, there is limited information available which quantifies improvement of postural stability following neuromuscular training designed to prevent ACL injuries in a healthy population. Methods and Measures: Forty-one healthy female high school athletes (mean age, 15.3 years; age range, 13-17 years) participated in this study. Single-limb postural stability for both lower extremities was assessed with a Biodex Stability System. The neuromuscular training program consisted of three 90-minute training sessions per week for 6 weeks. Following the completion of the training program, each subject was re-evaluated to determine change in total, anteriorposterior, and medial-lateral single-limb stability. Two-way analysis of variance models were used to determine differences between pretraining and posttraining and between limbs. Results: The subjects showed a significant improvement in single-limb total stability (P = .004) and anterior-posterior stability (P = .001), but not medial-lateral stability (P = .650) for both the right and left lower extremity following training. In addition, the subjects demonstrated significantly better total postural stability on the right side as compared to the left (P = .026). Conclusions: A 6-week neuromuscular training program designed to decrease the incidence of ACL injuries improves objective measures of total and anterior-posterior single-limb postural stability in high school female athletes.

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A Stabilometric Technique for Evaluation of Functional Instability in Anterior Cruciate Ligament-Deficient Knee

Cited by 24 publications

References 0 publications

Rehabilitation After Anterior Cruciate Ligament Reconstruction: Criteria-Based Progression Through the Return-to-Sport Phase

Rehabilitation After Anterior Cruciate Ligament Reconstruction: Criteria-Based Progression Through the Return-to-Sport Phase

Intratester and Intertester Reliability of Clinical Measures of Lower Extremity Anatomic Characteristics: Implications for Multicenter Studies

Neuromuscular Training Improves Single-Limb Stability in Young Female Athletes

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