Deficits in Neuromuscular Control of the Trunk Predict Knee Injury Risk

Zazulak, Bohdanna T.; Hewett, Timothy E.; Reeves, N. Peter; Goldberg, Barry; Cholewicki, Jacek

doi:10.1177/0363546507301585

Cited by 731 publications

(636 citation statements)

References 39 publications

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“…The core stability is defined as the ability to control the stem in response to the internal and external disturbances, and studies indicate that increased trunk stability decreases the risk of knee injuries, especially in women 23,24 . The return to sports training allows the patient to gradually experience the game situations, increasing thus the functional ability and confidence of the athlete.…”

Section: Discussionmentioning

confidence: 99%

Physical therapy in the conservative treatment for anterior cruciate ligament rupture followed by contralateral rupture: case report

Almeida

Arruda²,

Marques³

2014

Fisioter. Pesqui.

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| Although the surgical reconstruction be the obvious indication for the anterior cruciate ligament (ACL) lesion, there is no consensus on whether the results of surgery are superior to those obtained with nonsurgical management. The objective of this report was to describe a case of nonsurgical treatment for ACL rupture followed by a contralateral rupture. A 28-year-old female practitioner of muay-thai and handball suffered a non-contact ACL rupture in the left knee, and three months after the end of rehabilitation, the patient suffered a second non-contact ACL rupture in the contralateral knee and also received nonsurgical treatment. After both ruptures the patient received a treatment program focused on the strengthening of the quadriceps and hamstring muscles, trunk stabilization, plyometrics exercises, perturbation training, and return-to-sport training. After the treatments the patient exhibited absence of pain; normal muscular function and knee extension and flexion strength; normal range of motion; normal hop tests (<10% difference between members); improvement in the knee functional capacity and total return to normal activities. After two years of follow-up, the patient remained pain free and with normal knee function. The findings demonstrate the physical therapy effects in the nonsurgical treatment of bilateral ACL rupture. The patient could return to sport practice without instability.Physical therapy in the conservative treatment for anterior cruciate ligament rupture followed by contralateral rupture: case report Further studies with a larger sample are needed to assess the recovery capacity and the full return to sport activities of patients with ACL injury.Keywords | Physical Therapy Specialty; Knee; Anterior Cruciate Ligament.RESUMO | A reconstrução cirúrgica é a indicação mais frequente no tratamento da lesão do ligamento cruzado anterior (LCA). No entanto, não existe consenso de que seus resultados sejam superiores ao tratamento não cirúr-gico. Dessa forma, o objetivo deste estudo foi descrever o efeito do tratamento conservador com fisioterapia em um caso de lesão bilateral do LCA em momentos diferentes. Mulher, 28 anos de idade, praticante de muay-thai e handebol, inicialmente sofreu lesão do LCA do joelho esquerdo e três meses depois da alta fisioterapêutica sofreu lesão do LCA contralateral. Nas duas lesões a paciente foi tratada conservadoramente com fisioterapia, com foco no fortalecimento de quadríceps e isquiotibiais, estabilização do tronco, pliometria, treino sensório-motor e, no final, treino de retorno ao esporte. Após os tratamentos, a paciente apresentou ausência de dor, função muscular e amplitude de movimento dos joelhos normais, ausência de instabilidade, testes de salto dentro da normalidade (diferença <10% entre os membros), melhora na função do joelho

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Section: Discussionmentioning

confidence: 99%

Physical therapy in the conservative treatment for anterior cruciate ligament rupture followed by contralateral rupture: case report

Almeida

Arruda²,

Marques³

2014

Fisioter. Pesqui.

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“…Whether the hip joint is the cause of dysfunction or the victim, there has been evidence since 1939 that there exists a chain of adaptive reactions changing movement patterns throughout the system. This can occur from the foot up to the pelvis and from the trunk down to the foot [53][54][55][56][57][58][59]. Bullock-Saxton [60] and Janda [40] demonstrated this further in examining muscle activation patterns in male athletes who had chronic ankle sprains (> four months).…”

Section: Layer Iv: Neuro-mechanical Layermentioning

confidence: 96%

The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment

Draovitch

Edelstein

Kelly

2012

Curr Rev Musculoskelet Med

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The level of understanding of pain in the nonarthritic hip has made significant strides in the last couple of decades beginning with the discoveries of Reinhold Ganz, MD. However, even with the detection of subtle bony abnormalities, including femoroacetabular impingement, a clinician's ability to differentiate pain generators in the hip has been ambiguous. Deciphering the etiology of the pathology versus the pain generator is essential in prescribing the proper treatment. The Layer Concept developed by Dr. Bryan Kelly, is a systematic means of determining which structures about the hip are the source of the pathology, which are the pain generators and how to then best implement treatment. Four layers will be discussed in this article. Layer I, the osseous layer, Layer II, the inert tissue layer, Layer III, the contractile layer and Layer IV, the neuromechanical layer.

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“…Recent reports have shown that decreased neuromuscular control and high-risk biomechanics of movement are predictors of injury and re-injury [74][75][76]. Improved understanding of these biomechanical, anatomic, and kinematic risk factors of ACL injuries has led to the development of ACL injury prevention programs.…”

Section: Risk Factors and Preventionmentioning

confidence: 99%

Anterior cruciate ligament reconstruction in skeletally immature patients

Pennock

Murphy

2016

Curr Rev Musculoskelet Med

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The management of pediatric patients with an anterior cruciate ligament (ACL) tear can be a challenging endeavor for physicians, athletic trainers, coaches, and parents alike. In particular, the significant longitudinal growth that arises from the physes about the knee creates a unique set of circumstances that must be considered in this patient population. The purpose of this review is to provide a summary of the most recent current literature for the management of skeletally immature patients with an ACL tear.

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Deficits in Neuromuscular Control of the Trunk Predict Knee Injury Risk

Abstract: Factors related to core stability predicted risk of athletic knee, ligament, and ACL injuries with high sensitivity and moderate specificity in female, but not male, athletes.

Cited by 731 publications

References 39 publications

Physical therapy in the conservative treatment for anterior cruciate ligament rupture followed by contralateral rupture: case report

Physical therapy in the conservative treatment for anterior cruciate ligament rupture followed by contralateral rupture: case report

The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment

Anterior cruciate ligament reconstruction in skeletally immature patients

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