A performance test simulating components of sports was devised to evaluate dysfunction after ACL injury. The test included a one-leg hop, running in a figure of eight (straight running and turn running measured separately), running up and down a spiral staircase, and running up and down a slope. Twenty-six men with ACL injury, most of them soccer players, and 66 uninjured male soccer players were studied. Patients with ACL injury performed significantly less well than the uninjured players. Test items of special interest were turn running in the figure of eight, stair running, and slope running, all of which place high demand on the knee. It is concluded that a performance test of this design is useful for monitoring rehabilitation and for evaluating the patient's condition. Before sports can be resumed at the original level, normal strength and normal performance should be regained.
Postural controla comparison between patients with chronic anterior cruciate ligament insufficiencv and healthy individuals Lysholm M, Ledin T, Odkvist LM, Good L. Postural controla comparison between patients with chronic anterior cruciate ligament insufficiency and healthy individuals.Scand average of 86% of the total resisting force (1). Markolf et al.(2) postulated that the factors influencing knee stability during weight-bearing activities were provided by interactions of many phenomena, including ligament and other soft tissue restraints, condylar geometry, active muscular control and tibio-femoral contact forces.It has, however, become apparent that the ACL
It may be assumed that exercises that provoke high sagittal plane knee translations also induce high stresses on an anterior cruciate ligament substitute and, therefore, these exercises should be limited during the first months after reconstruction. In 18 patients with unilateral anterior cruciate ligament deficiency, sagittal plane knee translations were measured with a goniometer linkage system during common activities. The largest translations were found during low‐speed isokinetic exercises. Further, isokinetic and isometric exercises on the Cybex‐II dynamometer provoked in more than 40% of the patients larger translations on the injured than on the healthy knee. However, isometric exercises without distally applied load only provoked small translation. During bicycling, translations increased with increasing resistance similarly in both limbs. Except for walking downstairs, load‐bearing exercises, such as sitting down and standing up from a chair and walking upstairs, only produced negligible amounts of tibial translation. In conclusion, during the early phase after anterior cruciate ligament reconstruction, activities such as bicycling and some weightbearing exercises seem to be more recommendable than low‐speed isokinetic exercises, isometric contractions at a low knee flexion angle with distally applied load or walking downstairs.
We have evaluated the results after rehabilitation and compared this to inferior capsular shift in patients with multidirectional hyperlaxity (MDH). The patients (n=35) experienced either instability and/or pain. We divided the patients into two groups: one group (group A) included patients with MDH and only pain but no symptoms of instability (n=6). All these patients had initial rehabilitation, followed by surgery in four cases. None of the patients with only pain (n=6) were satisfied after rehabilitation. Only two out of four were satisfied after surgery. In the second group (group B) were included patients who had MDH with both pain and instability. Six patients had surgery without prior rehabilitation and 20 patients had initial rehabilitation. Eight of these patients had surgical stabilization after unsuccessful rehabilitation. Less than half of the patients with MDH and instability (n=20) were satisfied after rehabilitation alone. Twelve of 14 patients were satisfied after surgery. We conclude that patients with MDH and only pain are difficult to treat. Patients with MDH and instability respond only moderately to the exercise program. Surgery, in combination with physiotherapy, should be the initial treatment when instability is the main symptom.
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