Clinical and functional outcomes and proprioception after a modified accelerated rehabilitation program following anterior cruciate ligament reconstruction with patellar tendon autograft

Karasel, Seide; Akpinar, Berrin; Gülbahar, Selmin; Baydar, Meltem; El, Özlem; Pınar, Halit; Tatari, Hasan; Karaoğlan, Osman; Akalin, Elif

doi:10.3944/aott.2010.2293

Cited by 37 publications

(47 citation statements)

References 37 publications

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“…29 Although several studies have reported persistent symmetry deficits in hop tests following ACLR, 4,13,16 only recently have researchers performed thorough analyses of the biomechanics associated with the observed functional deficits during these maneuvers. 18,21,31 As yet, to the authors' knowledge, no study has comprehensively investigated lower extremity kinematics, muscular strength, and functional performance in a homogeneous group of patients 6 to 9 months post-ACLR. Nor has there been a study that has evaluated both the propulsion and landing phases by investigating the kinematics of the hip, knee, and ankle during these commonly used hop tests.…”

Section: U U Resultsmentioning

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

124

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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Section: U U Resultsmentioning

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

124

131

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“…Proprioception at knee joint is often measured with the "passive and AJPS" method. [19][20][21][22] AJPS stimulates both the joint and the muscle receptors and helps measure the afferent paths in a more functional manner. 11 However, these two methods are conducted without applying weight on the knee joint.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, there are studies in the literature that were performed with different grafts and that compared proprioception at 15°and 60°flexion following the ACL reconstruction with the healthy control group. [19][20][21][22][27][28][29] Risberg et al found the knee proprioception similar at 15°knee flexion angle in the patient and the control group approximately 2 years after the anterior cruciate ligament reconstruction with patellar tendon autograft. 27 Another study used AJPS evaluated proprioception on 15 patient and 15 healthy elite sportsmen with the isokinetic dynamometer 19 months after the ACL reconstruction with hamstring tendon autograft.…”

Section: Discussionmentioning

confidence: 99%

Proprioception following the Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Tendon Allograft

2019

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After the anterior cruciate ligament (ACL) reconstruction, a loss of proprioception is observed and it can continue years after the operation. The aim of this study is to evaluate proprioception in standing position at different knee flexion angles in patients who underwent ACL reconstruction with tibialis anterior tendon allograft. The study included 34 patients who underwent ACL reconstruction with tibialis anterior tendon allograft and 34 healthy individuals. Proprioception was evaluated in standing position at 15°, 30°, 60° flexion angles with the active joint position sense (AJPS) method using digital inclinometer. Proprioception deviation angle was found to be higher in the operated leg at 30° and 60° flexion angles in the patient group compared with the other leg (p < 0.05), the biggest proprioception difference was between the 15° and 60° flexion angles in both the patient and the control group (p < 0.05) that the difference between 15° and 30° flexion angles is lowest (p < 0.05), and that these differences are higher in the operated leg of the patient group compared with the other leg of the patient group and to the dominant leg of the control group (p < 0.05). As approximately 4 years after ACL reconstruction with tibialis anterior tendon allograft, loss of proprioception at 60° knee flexion continued, ACL injury related to loss of proprioception may occur at angles higher than 30° flexion. Thus, patients may be provided with proprioception-enhancing rehabilitation in the long term, particularly, at flexion angles above medium levels.

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“…The static and dynamic postural stability was similar between the involved and uninvolved side knees in each group. An injury to the ACL can compromise the neuromuscular function of the knee joint, resulting in impaired proprioception and dynamic stability of the knee joint [21][22][23]. Recent studies have suggested that the menisci also have important roles in neuromuscular control of the knee joint [1,24,25].…”

Section: Discussionmentioning

confidence: 99%

Poorer dynamic postural stability in patients with anterior cruciate ligament rupture combined with lateral meniscus tear than in those with medial meniscus tear

Lee

Park

et al. 2020

Knee Surg & Relat Res

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Background: Only limited data are available regarding postural stability between anterior cruciate ligament (ACL)injured patients with medial meniscus (MM) tear and those with lateral meniscus (LM) tear. The purpose of this study was to compare preoperative postural stability for both involved and uninvolved knees in ACL rupture combined with MM and LM tears. It was hypothesized that there would be a significant difference in postural stability between these two groups. Methods: Ninety-three ACL-injured patients (53 combined with MM tears vs. 40 combined with LM tears) were included. Static and dynamic postural stability were evaluated with the overall stability index (OSI), anteriorposterior stability index (APSI), and medial-lateral stability index (MLSI) using stabilometry. Knee muscle strength was evaluated using an isokinetic testing device. Results: In the static postural stability test, none of the stability indices showed significant differences between the two groups for both knees (p > 0.05). In the dynamic postural stability test for involved side knees, the OSI and APSI were significantly higher in the LM tear group compared to the MM tear group (OSI: 2.0 ± 0.8 vs. 1.6 ± 0.5, p = 0.001; APSI: 1.5 ± 0.6 vs. 1.3 ± 0.5, p = 0.023), but not the MLSI (p > 0.05). In the static and dynamic postural stability tests in each group, there were no significant differences between the involved and uninvolved side knees (p > 0.05). There was no significant difference in the knee muscle strength between the two groups (p > 0.05). All postural stability showed no significant correlation with knee muscle strength (p > 0.05). Conclusion: Dynamic postural stability was poorer in patients with ACL rupture combined with LM tear than in those with MM tear. Therefore, close monitoring for postural stability would be necessary during preoperative and postoperative rehabilitation, especially for patients with ACL rupture combined with LM tear.

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Clinical and functional outcomes and proprioception after a modified accelerated rehabilitation program following anterior cruciate ligament reconstruction with patellar tendon autograft

Abstract: We had satisfactory clinical, proprioceptive, and functional results in achieving dynamic and static stability of the knee with the modified accelerated rehabilitation program after ACL reconstruction with a PT graft.

Cited by 37 publications

References 37 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

Proprioception following the Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Tendon Allograft

Poorer dynamic postural stability in patients with anterior cruciate ligament rupture combined with lateral meniscus tear than in those with medial meniscus tear

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