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

Abstract

PurposeThe purpose of this study was to utilize a novel functional test system to facilitate determining the time of return to sports following ACL reconstruction.MethodsSixty-nine patients with unilateral ACL reconstruction were included in this pilot study. All the patients performed a standardized test battery consisting of one- and two-legged stability tests, counter movement jumps, speedy jumps, plyometric jumps and a quick feed test. The first test was administered on average 170.7 ± 75.1 days post-operatively, and the retest was administered on average 239.1 ± 79.7 days post-operatively. The values of the subtests were compared with the normative data of healthy gender- and age-matched controls to determine the functional capacities of patients following ACL reconstruction.ResultsAfter the first and second test, 15.9 and 17.4 % of the patients met the criteria for a “return to non-competitive sports”. One patient fulfilled the criteria for a “return to competitive sports” after the second test battery. The most limiting factor was a poor LSI value of <90 % if the dominant leg was involved and <80 % if the non-dominant leg was involved.ConclusionThis test battery demonstrates that, in terms of neuromuscular abilities, most patients, compared to healthy controls, are most likely not ready for a safe return to sports, even 8 months post-operatively. This should be considered in the future to determine when it is safe to return to sports and should avoid a premature return to competitive sports.Level of evidenceIII.

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

“…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. Others suggest that home-based rehabilitation is as effective as supervised rehabilitation 53 56 57.…”

ACL Return to Sport Guidelines and Criteria

“…Although multiple parameters for RTS have been described, our focus will be on the criteria authors consider most important for a successful RTS. One assessment method based on the use of a FTA, which has been used by the senior author for 37 years, will be described in detail and forms the foundation of this article [23] (Table 1).…”

Evidenz-basierte Return-to-Sport-Testung nach Gelenkeingriffen

“…Es stehen heute eine große Palette an verschiedenen funktionellen Tests und Kombinationen zum muskuloskelettalen Screening zur Verfügung, die zur Prü-fung auf das Verletzungsrisiko beim Wiedereinstieg in den Sport geeignet sind [9]. Jedoch stehen dem einige Limitationen gegenüber.…”