Functional assessments for decision-making regarding return to sports following ACL reconstruction. Part I: development of a new test battery

Abstract

PurposeReturn to activity remains the most common concern following an injury. To facilitate the decision regarding a patient’s return to sport, we developed a standardized and easy-to-use test battery to enable an objective evaluation of knee function.MethodsThe test battery consisted of seven functional tests: the two-leg stability test, one-leg stability test (OL-ST), two-leg countermovement jump (CMJ), one-leg CMJ (OL-CMJ), plyometric jumps, speedy test and quick feet test. For each test, the reliability was determined based on the intraclass correlation coefficient. For all one-leg tests, the limb symmetry index (LSI) was calculated. ResultsAll tests showed a moderate-to-high reliability. Normative data from 434 participants were included in the analysis. The subjects were categorized according to age as follows: children (10–14 years), youth (15–19 years), young adults (20–29 years) and adults (30–50 years). The establishment of the functional test values allowed the classification into five normative categories. The LSI for the OL-ST (98 %) indicated a better performance of the non-dominant leg. In contrast, high LSI values were found for the OL-CMJ (124 %), indicating a better performance of the dominant leg.ConclusionEach test was found to be reliable and simple to perform. The better performance of the non-dominant leg in stability tasks must be considered when interpreting side-to-side differences. The established norm data from healthy individuals of each test battery represents an important basis for a clinical setting. Test results from an ACL-reconstructed patient should be at least classified as a functionally average outcome to support a safe return to sports.Level of evidenceIV.

Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus

“…This term differs from a previous ACLR rehabilitation protocol by van Grinsven et al ,51 who presented a 22-week rehabilitation with four time-based phases. Recent evidence suggests that longer rehabilitation periods are needed, because most patients are not able to reach the end-rehabilitation goals in 22 weeks 129 130. Herbst et al 131 presented a new functional performance test battery and concluded that most patients were not ready for return to play even at 8 months after ACLR.…”

Return to sport testing after anterior cruciate ligament reconstruction has marginal psychological impact: a randomised controlled trial

“…Similar to our QMA-RTS programme, their findings demonstrated that the vast majority of patients were not physically ready to return to sport 6 months after surgery according to the goals prescribed. Another test battery included functional tests such as SL and double-leg stability tests and jumps as well as speed tests 23. Their main outcome was the limb symmetry index (LSI).…”

Correlação entre avaliação física virtual e de desempenho funcional em mulheres: Um estudo piloto

“…Dentre os testes de desempenho funcional mais utilizados, destacam-se aqueles que avaliam o desempenho por meio de saltos verticais e em distância, utilizando apoio unipodal e bipodal 5,6 , não apenas em indivíduos saudáveis, mas também em populações específicas como pacientes após reconstrução do ligamento cruzado anterior (LCA), visando o retorno seguro à prática esportiva 5,7 . Entretanto, questiona-se se esses testes são realmente bons preditores de lesão ou recidivas, reforçando a utilização de um conjunto maior de avaliações clínicas para melhor identificar possíveis déficits funcionais 8 .…”