Contralateral limb strength deficits after anterior cruciate ligament reconstruction using a hamstring tendon graft

Hiemstra, Laurie A.; Webber, Sandra C.; MacDonald, Peter B.; Kriellaars, Dean

doi:10.1016/j.clinbiomech.2007.01.009

Cited by 137 publications

(115 citation statements)

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“…In recent investigations, Bolgla et al 4 reported that participants with patellofemoral pain syndrome displayed 24% less hip external rotator (ER) and 26% less abductor strength then control participants, whereas Souza and Powers 2 reported that individuals with patellofemoral pain syndrome were 15% weaker in the hip abductors (ABs) and 16% weaker in the hip extensors (HEs) than asymptomatic individuals. Researchers [6][7][8] have also reported strength deficits at the knee as compared with both the contralateral limb and matched controls 1 to 2 years after anterior cruciate ligament reconstruction. Depending on the surgical technique used (eg, bone-patellar tendon-bone or biceps semitendinosus) and muscle group (ie, knee flexors [KFs] or knee extensors [KEs]) assessed, researchers have found these differences to be as great as 11% to 25%.…”

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confidence: 99%

The Reliability of Portable Fixed Dynamometry During Hip and Knee Strength Assessments

Kollock

Oñate

Lunen

2010

Journal of Athletic Training

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Context: Insufficient lower extremity strength may be a risk factor for lower extremity injuries such as noncontact anterior cruciate ligament tears. Therefore, clinicians need reliable instruments to assess strength deficiencies.Objective: To assess the intrarater, interrater, intrasession, and intersession reliability of a portable fixed dynamometer in measuring the strength of the hip and knee musculature.Design: Crossover study. Setting: Sports medicine research laboratory.Patients or Other Participants: Three raters (A, B, C) participated in this 2-phase study. Raters A and B tested 11 healthy college graduate students (2 men, 9 women) in phase 1. Raters A and C tested 26 healthy college undergraduate students (7 men, 19 women) in phase 2.Main Outcome Measure(s): The dependent variables for the study were hip adductor, hip abductor, hip flexor, hip extensor, hip internal rotator, hip external rotator, knee flexor, and knee extensor peak force.Results: The phase 1 intrasession intraclass correlation coefficients for sessions 1, 2, and 3 ranged from 0.88 to 0. Conclusions: The portable fixed dynamometer showed good to high intrasession and intersession reliability values for hip and knee strength. Intrarater and interrater reliability were fair to high, except for hip internal rotation, which showed poor reliability.

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confidence: 99%

The Reliability of Portable Fixed Dynamometry During Hip and Knee Strength Assessments

Kollock

Oñate

Lunen

2010

Journal of Athletic Training

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“…Specifically, when compared with the uninjured limb, the injured leg displayed strength deficits of 33% in the knee extensors and 10% in the knee flexors. Previously reported kneeextensor and -flexor strength deficits vary, ranging from 5% to 40% 2-10 and 9% to 27%, 2,3,5,8,9,11 respectively. The presence of greater knee-extensor and -flexor weakness in the injured than in the uninjured limb in our participants seems to confirm that current rehabilitation strategies do not fully restore strength by the time that individuals return to activity.…”

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confidence: 99%

Lower Extremity Muscle Strength After Anterior Cruciate Ligament Injury and Reconstruction

Thomas¹,

Villwock²,

Wojtys³

et al. 2013

Journal of Athletic Training

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Arbor. Dr Thomas is now with the Department of Kinesiology, University of Toledo, OH.Context: Quadriceps and hamstrings weakness occurs frequently after anterior cruciate ligament (ACL) injury and reconstruction. Evidence suggests that knee injury may precipitate hip and ankle muscle weakness, but few data support this contention after ACL injury and reconstruction.Objective: To determine if hip, knee, and ankle muscle weakness present after ACL injury and after rehabilitation for ACL reconstruction.Design: Case-control study. Setting: University research laboratory.Patients or Other Participants: Fifteen individuals with ACL injury (8 males, 7 females; age ¼ 20.27 6 5.38 years, height ¼ 1.75 6 0.10 m, mass ¼ 74.39 6 13.26 kg) and 15 control individuals (7 men, 8 women; age ¼ 24.73 6 3.37 years, height ¼ 1.75 6 0.09 m, mass ¼ 73.25 6 13.48 kg).Intervention(s): Bilateral concentric strength was assessed at 608/s on an isokinetic dynamometer. The participants with ACL injury were tested preoperatively and 6 months postoperatively. Control participants were tested on 1 occasion.Main Outcome Measures: Hip-flexor, -extensor, -abductor, and -adductor; knee-extensor and -flexor; and ankle-plantarflexor and -dorsiflexor strength (Nm/kg).Results: The ACL-injured participants demonstrated greater hip-extensor (percentage difference ¼ 19.7, F 1,14 ¼ 7.28, P ¼ .02) and -adductor (percentage difference ¼ 16.3, F 1,14 ¼ 6.15, P ¼ .03) weakness preoperatively than postoperatively, regardless of limb, and greater postoperative hip-adductor strength (percentage difference ¼ 29.0, F 1,28 ¼ 10.66, P ¼ .003) than control participants. Knee-extensor and -flexor strength were lower in the injured than in the uninjured limb preoperatively and postoperatively (extensor percentage difference ¼ 34.6 preoperatively and 32.6 postoperatively, t 14 range ¼À4.59 to À4.23, P .001; flexor percentage difference ¼ 30.6 preoperatively and 10.6 postoperatively, t 14 range ¼ À6.05 to À3.24, P , .05) with greater knee-flexor (percentage difference ¼ 25.3, t 14 ¼À4.65, P , .001) weakness preoperatively in the injured limb of ACLinjured participants. The ACL-injured participants had less injured limb knee-extensor (percentage difference ¼ 32.0, t 28 ¼ À2.84, P ¼ .008) and -flexor (percentage difference ¼ 24.0, t 28 ¼ À2.44, P ¼ .02) strength preoperatively but not postoperatively (extensor: t 28 ¼ À1.79, P ¼ .08; flexor: t 28 ¼ 0.57, P ¼ .58) than control participants. Ankle-plantar-flexor weakness was greater preoperatively than postoperatively in the ACL-injured limb (percentage difference ¼ 31.9, t 14 ¼ À3.20, P ¼ .006).Conclusions: The ACL-injured participants presented with hip-extensor, -adductor, and ankle-plantar-flexor weakness that appeared to be countered during postoperative rehabilitation. Our results confirmed previous findings suggesting greater knee-extensor and -flexor weakness postoperatively in the injured limb than the uninjured limb. The knee extensors and flexors are important dynamic stabilizers; weakness in these muscles could i...

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“…For muscular capacity, 11 studies have looked into its association with sustaining a non-contact ACL injury (Ahmad, et al, 2006;Bee-Oh, et al, 2009;Bowerman, Smith, Carlson, & King, 2006;Grygorowicz, Kubacki, Pilis, Gieremek, & Rzepka, 2010;Hiemstra, Webber, MacDonald, & Kriellaars, 2007;Holcomb, Rubley, Lee, & Guadagnoli, 2007;Hosokawa, et al, 2011;Mattacola, et al, 2002;Roberts, Ageberg, Andersson, & Fridén, 2007;Wilkerson, et al, 2004;. These studies have associated muscular capacity with risks of acquiring ACL injury, validating ACL screening tools to be used in intervention programs to prevent ACL injury.…”

Section: Reflection On Associative Studiesmentioning

confidence: 99%

“…(Hiemstra, et al, 2007;Mattacola, et al, 2002;Roberts, et al, 2007;Wilkerson, et al, 2004; Isokinetic and isometric peak torques (Ahmad, et al, 2006;Bee-Oh, et al, 2009;Bowerman, et al, 2006;Grygorowicz, et al, 2010;Holcomb, et al, 2007;Hosokawa, et al, 2011). H:Q ratio Muscular Activation (Begalle, et al, 2012;Elias, et al, 2015;Nagano, et al, 2011;R.…”

Section: Author/yearmentioning

confidence: 99%

Mapping current research trends on neuromuscular risk factors of non-contact ACL injury

Rafeeuddin

Sharir

Staes

et al. 2016

Physical Therapy in Sport

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Contralateral limb strength deficits after anterior cruciate ligament reconstruction using a hamstring tendon graft

Cited by 137 publications

References 38 publications

The Reliability of Portable Fixed Dynamometry During Hip and Knee Strength Assessments

The Reliability of Portable Fixed Dynamometry During Hip and Knee Strength Assessments

Lower Extremity Muscle Strength After Anterior Cruciate Ligament Injury and Reconstruction

Mapping current research trends on neuromuscular risk factors of non-contact ACL injury

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