Single-Legged Hop Tests as Predictors of Self-Reported Knee Function in Nonoperatively Treated Individuals With Anterior Cruciate Ligament Injury

Grindem, Hege; Logerstedt, David; Eitzen, Ingrid; Moksnes, Håvard; Axe, Michael J.; Snyder‐Mackler, Lynn; Engebretsen, Lars; Risberg, May Arna

doi:10.1177/0363546511417085

Cited by 143 publications

(160 citation statements)

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“…20 The ACLR group in the current study had an average score of 72.4, which indicated that a majority were below the age-matched 15th percentile that is considered to be indicative of normal knee function. 2,19 Additionally, our ACLR group had IKDC and hop-performance scores that were below what has been reported for ACL-deficient patients 1 year after injury. 19 Recent research 3,33 has suggested that 9 months is not an adequate time for maximizing functional recovery after ACLR, which may explain the low scores in our sample and raises the possibility that further improvements may become evident at 1 year or later.…”

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confidence: 54%

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Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Xergia

Pappas²,

Zampeli³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

127

131

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Study Design Within-subject and between-subject cross-sectional study. Objectives To investigate symmetry in hop-test performance, strength, and lower extremity kinematics 6 to 9 months following anterior cruciate ligament reconstruction (ACLR). Background Despite the extensive body of literature involving persons following ACLR, no study has comprehensively evaluated measures of strength, lower extremity kinematics, and functional performance of functional hop tests in this population. Methods The subjects were 22 men (mean ± SD age, 28.8 ± 11.2 years) who had ACLR using a bone-patellar tendon-bone autograft 6 to 9 (7.01 ± 0.93) months previously and 22 healthy male controls (age, 24.8 ± 9.1 years). Participants completed a self-report questionnaire and underwent isokinetic strength testing and functional and kinematic assessment of the single-, triple-, and crossover-hop tests. Two-way analyses of variance were used to test for differences between the ACLR group and the control group, and between the 2 lower extremities of the ACLR group. Results Compared to the control group, the ACLR group had greater isokinetic knee extension torque deficits at all speeds (P≤.001) and greater performance asymmetry for all 3 hop tests (P<.001). Compared to the noninvolved lower extremity, the involved lower extremity of the ACLR group exhibited less ankle dorsiflexion and knee flexion in the phases of propulsion (P≤.014) and landing (P≤.032). When compared to the control group, the involved lower extremity exhibited less ankle dorsiflexion in the propulsion phase (P<.001) but higher hip flexion in the landing phase (P = .014). Conclusion Six to 9 months following ACLR, patients continue to demonstrate functional hop and isokinetic knee extension deficits, as well as kinematic differences, during the propulsion and landing phases of the hop tests. J Orthop Sports Phys Ther 2013;43(3):154–162. Epub 14 January 2013. doi:10.2519/jospt.2013.3967

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confidence: 54%

“…The IKDC has been shown to be reliable, valid, and responsive in the ACL-injured population. 19 The Tegner activity scale is a measure of activity level that ranges from 0 (sick leave or disability because of knee problems) to 10 (competitive sports at national elite level).…”

Section: Self-reported Questionnairementioning

confidence: 99%

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Xergia

Pappas²,

Zampeli³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

127

131

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“…Several studies have found that lower extremity functional performance test results predict future functional outcome, 1,8,12,21,22 indicating their usefulness in lower extremity rehabilitation.…”

Section: 19mentioning

confidence: 99%

“…Consequently, these tests can reveal impairments in muscle force generation or proprioception and neuromuscular control that might not be obvious with other clinical measures. 7,19 Several studies have found that lower extremity functional performance test results predict future functional outcome, 1,8,12,21,22 indicating their usefulness in lower extremity rehabilitation.…”

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confidence: 99%

Normalization Considerations for Using the Unilateral Seated Shot Put Test in Rehabilitation

Chmielewski¹,

Martin²,

Lentz³

et al. 2014

Journal of Orthopaedic & Sports Physical Therapy

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Functional performance testing is often used in lower extremity rehabilitation to help determine a patient's readiness to return to sports participation. 2,11,25,28 Hopping or jumping tasks are most commonly used, 3,18,25,28 but other types of tasks also exist. 2,15Functional performance tests impart high forces to an injured joint or body segment that may more closely replicate the forces experienced in sport. Consequently, these tests can reveal impairments in muscle force generation or proprioception and neuromuscular control that might not be obvious with other clinical measures. 7,19Several studies have found that lower extremity functional performance test results predict future functional outcome, 1,8,12,21,22 indicating their usefulness in lower extremity rehabilitation.Functional performance testing is not standard in upper extremity rehabilitation and is absent from most upper extremity rehabilitation protocols. 5,23,27 The lack of functional performance testing occurs in spite of several functional performance tests described for the upper extremity. 4,6,17,24 A dearth of research to guide the selection and implementation of upper extremity functional performance tests may be a barrier to more widespread clinical use.The unilateral seated shot put test is an upper extremity functional performance test with many appealing aspects for clinical use. The test requires pushing a weighted ball forward in a shot put motion. 16 The test requires little equipment and would therefore be easy to administer in most clinical settings. Distance thrown on the unilateral seated shot put test has shown positive correlation with distance on a softball throw, providing external validity. 17 Moreover, in a sample T T STUDY DESIGN: Cross-sectional study. T T OBJECTIVES:To examine the effect of different normalization methods on unilateral seated shot put test results. T T BACKGROUND:The unilateral seated shot put test could assist clinical decision making in upper extremity rehabilitation, but test results must be normalized to compare across patients. The effect of normalization methods based on body size and upper-limb dominance is unknown. T T METHODS:One hundred twenty-five collegiate athletes (63 males) performed the unilateral seated shot put test with each upper extremity. Anthropometric measures (height, body mass, arm length) and distance thrown were recorded. Normalization based on body size included ratio scaling and allometric scaling. Ratio scaling was performed with the anthropometric measure having the highest correlation to distance thrown (distance/anthropometric measure). Allometric scaling was performed with body mass raised to the theoretical exponent 0.67 (distance/body mass 0.67 ) and a derived exponent. Correlations of nonnormalized and normalized values with body mass were then determined. The limb symmetry index [(dominant-side distance/nondominantside distance) × 100] was used for normalization based on limb dominance. Sex differences were examined. T T RESULTS:Body mass was selected for ratio...

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“…The single leg hop test for distance (SLHD) was first described by Daniel et al (1982); however, there are now a number of variations available that assess a range of functional limitations associated with ACL deficiency (Daniel et al, 1982;Daniel, Stone, Riehl, & Moore, 1988;Grindem et al, 2011;Gustavsson et al, 2006;Kramer, Nusca, Fowler, & Webster-Bogaert, 1992;Logerstedt et al, 2012). A single leg vertical jump, single leg triple hop for distance, cross over single leg hop for distance and timed six-metre single leg hop are some of the common variations (Gustavsson et al, 2006;Noyes, Barber, & Mangine, 1991).…”

Section: Single Leg Hop Testsmentioning

confidence: 99%

Graft tensioning in anterior cruciate ligament reconstruction

Kirwan¹

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BackgroundAnterior cruciate ligament reconstruction (ACLR) is an effective procedure for restoring stability and function. Being a technically demanding procedure, patient outcomes are highly dependent on numerous surgical factors, which are critical for success. The application of tension to the graft prior to tibial fixation is one such factor and is considered essential for the restoration of joint stability, normal knee biomechanics, graft revascularisation and patient function. In applying tension, a key factor is the amount of force applied to the graft. However, the method of applying the tension, position of the knee during tensioning, properties of the graft material, tunnel placement and graft fixation device can all influence the effect that graft tension has on outcomes. Despite the reported importance of graft tension there has been limited empirical evidence defining the best tensioning practice for restoring patient outcome post ACLR. AimsThe goal of this program of research was to explore the effect that different aspects of graft tensioning has on patient function post ACLR. To address the aims of the thesis, three studies were conducted. The first study was a systematic review aimed at examining if a particular amount of tension results in better functional outcomes post ACLR. The second study aimed to compare the effect of two methods of applying graft tension on patient function post ACLR. The study used a prospective randomised controlled trial to compare manual tensioning with the use of a tensioning device. The third study aimed to define current graft tensioning practices and explore the factors that influence surgical decision making. A national survey of Australian orthopaedic surgeons was conducted to achieve the aims of the study. ResultsThe systematic review (study one) revealed that a medium graft tension of 79N to 90N produced the least side-to-side difference (STSD) in anterior posterior (AP) tibial translation as measured by a KT-1000 when compared to tensions <79 or >90N. However, the heterogeneous use of functional outcomes inhibited the ability to draw conclusions on other patient specific functional outcomes.Furthermore, the review highlighted the lack of high quality studies, which also failed to discuss other aspects of graft tension such as the method of applying tension.iii Building on the findings of study one, the second study undertook a RCT to compare the functional outcomes of applying 80N of force with a tensioning device (TD) (n=10) to a manual tensioning method (MT) (n=13) using an estimated force described as a sustained maximum one handed pull.Patients were assessed at pre-surgery and two weeks, three months, six months and 12 months post Based on the findings of study one, tensioning between 79N and 90N appeared to improve the restoration of joint stability, when compared to higher and lower tensions. However, no effect on patient function within 24 months post surgery was apparent. Furthermore, study two observed that tension did not appear to have an...

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Single-Legged Hop Tests as Predictors of Self-Reported Knee Function in Nonoperatively Treated Individuals With Anterior Cruciate Ligament Injury

Cited by 143 publications

References 40 publications

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Normalization Considerations for Using the Unilateral Seated Shot Put Test in Rehabilitation

Graft tensioning in anterior cruciate ligament reconstruction

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