Asymmetrical Lower Extremity Loading After ACL Reconstruction: More Than Meets the Eye

Chmielewski, Terese L.

doi:10.2519/jospt.2011.0104

Cited by 45 publications

(42 citation statements)

References 26 publications

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“…29 Lastly, using LSI in research and clinical practice for rehabilitation has been frequently questioned as it may conceal results of physical performance, in particular during longterm observational studies. 30 It has been argued that asymmetry alone cannot be used to understand which of the two limbs has improved or worsened. However, while this limitation applies to single-legged tasks, it may not be relevant to double-legged functional movements looking at how load was managed between the two limbs.…”

Section: Discussionmentioning

confidence: 99%

Asymmetrical Lower Extremity Loading Early After Anterior Cruciate Ligament Reconstruction Is a Significant Predictor of Asymmetrical Loading at the Time of Return to Sport

Labanca

Laudani²,

Menotti

et al. 2016

American Journal of Physical Medicine &Amp; Rehabilitation

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Objectives: To examine whether asymmetrical lower limb loading early after ACL reconstruction (one month) can predict asymmetrical lower limb loading at the time of return to sport (6 months) and whether other early predictors as knee joint range of motion or maximal isometric strength affect this relationship.Design: Ground reaction forces were measured during a sit to stand task (STS) one month after ACL reconstruction and a vertical countermovement jump (CMJ) 6 months after ACL reconstruction in 58 athletes. Other early post-operative measurements were knee joint range of motion (2 weeks, 1 month and 2 months after surgery) and maximal isometric strength of the knee extensor and flexor muscles (2 months after surgery). Linear regression models were developed using side-to-side limb symmetry index (LSI) of CMJ as the dependent variable.Results: LSI of STS 1 month after surgery was a significant independent predictor of LSI of CMJ 6 months after surgery. After accounting for deficits in knee joint range of motion and LSI of maximal isometric strength (ΔR 2 =0.35 p<0.01), LSI of STS predicted LSI of CMJ (ΔR 2 =0.14 p<0.01). Conclusions:Asymmetrical lower extremity loading one month after ACL reconstruction is an early predictor of asymmetrical lower extremity loading 6 months after surgery.

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Section: Discussionmentioning

confidence: 99%

Asymmetrical Lower Extremity Loading Early After Anterior Cruciate Ligament Reconstruction Is a Significant Predictor of Asymmetrical Loading at the Time of Return to Sport

Labanca

Laudani²,

Menotti

et al. 2016

American Journal of Physical Medicine &Amp; Rehabilitation

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“…4 If these systems are not available, a skilled eye that has experience observing various movement patterns will suffice. Eventually, having movement-based qualitative standards for performance and skilllevel tasks would also be helpful, just as the FMS is currently used to screen and rank dysfunctional and/or painful fundamental movement.…”

Section: Tablementioning

confidence: 99%

“…rehabilitation, as evidence suggests that it is a useful tool to predict injury risk in multiple populations 5,13,29 and it allows one to see if satisfactory results on measures of impairment at a specific joint correlate with multisegmental movement competency and adequate motor control before the body is under higher stress in an advanced stage of rehabilitation. For similar reasons, a tool like the Y Balance Test could be used to determine if asymmetry exists in the weight-bearing function of the lower extremities.…”

mentioning

confidence: 99%

Suggestions From the Field for Return to Sports Participation Following Anterior Cruciate Ligament Reconstruction: American Football

Verstegen¹,

Falsone²,

Orr³

et al. 2012

J Orthop Sports Phys Ther

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“…The amount of time between the injury and ACL reconstruction surgery was 4.3  2.8 (range, 2-9) months. The amount of time between preseason testing and the 6-month postsurgery assessment was 11.3  2.2 (range, [8][9][10][11][12][13][14] months. Finally, the amount of time between preseason testing and the 12-month postsurgery assessment was 18.5  2.8 (range, [15][16][17][18][19][20][21][22] months.…”

Section: Methodsmentioning

confidence: 99%

“…J Orthop Sports Phys Ther 2012;42 (9) to return athletes to unrestricted sports activities postsurgery are not demanding enough or that variables more important for safe return to unrestricted sports activities are not being evaluated postsurgery. A recent editorial 10 highlighted the potential for residual neuromuscular deficits to be present in both limbs following ACL injury and reconstruction.…”

Section: T T Conclusionmentioning

confidence: 99%

Rate of Force Development as an Adjunctive Outcome Measure for Return-to-Sport Decisions After Anterior Cruciate Ligament Reconstruction

Angelozzi¹,

Madama²,

Corsica³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

155

147

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Study Design Descriptive, prospective, longitudinal single-cohort study. Objective To investigate the rate of force development to 30% (RFD30), 50% (RFD50), and 90% (RFD90) of maximal voluntary isometric contraction (MVIC) as an adjunct outcome measure for determining readiness for return to sport following an anterior cruciate ligament (ACL) reconstruction. Background One criterion of full recovery following an ACL reconstruction is the ability to achieve 85% or 90% of the maximal strength of the contralateral limb. However, the time required to develop muscular strength in many types of daily and sports activities is considerably shorter than that required to achieve maximal strength. Therefore, in addition to maximal strength, neuromuscular functions such as RFD should also be considered in the definition of recovery. Methods Forty-five male professional soccer players who underwent an ACL reconstruction were recruited. Assessment with the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Tegner score, and KT1000 instrumented arthrometer was performed postinjury/prereconstruction and at 6 and 12 months after ACL reconstruction. MVIC, RFD30, RFD50, and RFD90 testing was performed preinjury, as part of standard preseason assessment, and at 6 and 12 months post-ACL reconstruction. Results The average MVIC value 6 months postreconstruction was 97% of the preinjury average value. In contrast, at 6 months, the RFD30, RFD50, and RFD90 values were 80% (P = .04), 77% (P = .03), and 63% (P = .007), respectively, of the preinjury values. The mean RFD values for the reconstructed knee attained or exceeded 90% of the preinjury mean values only at the 12-month post-ACL reconstruction assessment (RFD30, P = .86; RFD50, P = .51; RFD90, P = .56). Conclusion Despite the near recovery of MVIC strength to preinjury levels, there were still significant deficits in RFD at 6 months post-ACL reconstruction. An RFD similar to the preinjury RFD was achieved at 12 months post-ACL reconstruction, following a rehabilitation program focusing on muscle power. These results suggest that, following an ACL reconstruction, RFD criteria may be a useful adjunct outcome measure for the decision to return athletes to sports. J Orthop Sports Phys Ther 2012;42(9):772–780, Epub 19 July 2012. doi:10.2519/jospt.2012.3780

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Asymmetrical Lower Extremity Loading After ACL Reconstruction: More Than Meets the Eye

Cited by 45 publications

References 26 publications

Asymmetrical Lower Extremity Loading Early After Anterior Cruciate Ligament Reconstruction Is a Significant Predictor of Asymmetrical Loading at the Time of Return to Sport

Asymmetrical Lower Extremity Loading Early After Anterior Cruciate Ligament Reconstruction Is a Significant Predictor of Asymmetrical Loading at the Time of Return to Sport

Suggestions From the Field for Return to Sports Participation Following Anterior Cruciate Ligament Reconstruction: American Football

Rate of Force Development as an Adjunctive Outcome Measure for Return-to-Sport Decisions After Anterior Cruciate Ligament Reconstruction

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