Functional Performance Testing and Patient Reported Outcomes following ACL Reconstruction: A Systematic Scoping Review

Abstract

Objective. A systematic scoping review of the literature to identify functional performance tests and patient reported outcomes for patients who undergo anterior cruciate ligament (ACL) reconstruction and rehabilitation that are used in clinical practice and research during the last decade. Methods. A literature search was conducted. Electronic databases used included Medline, PubMed, Cochrane Library, EMBASE, CINAHL, SPORTDiscus, PEDro, and AMED. The inclusion criteria were English language, publication between April 2004 and April 2014, and primary ACL reconstruction with objective and/or subjective outcomes used. Two authors screened the selected papers for title, abstract, and full-text in accordance with predefined inclusion and exclusion criteria. The methodological quality of all papers was assessed by a checklist of the Critical Appraisal Skills Programme (CASP). Results. A total of 16 papers were included with full-text. Different authors used different study designs for functional performance testing which led to different outcomes that could not be compared. All papers used a measurement for quantity of functional performance except one study which used both quantity and quality outcomes. Several functional performance tests and patient reported outcomes were identified in this review. Conclusion. No extensive research has been carried out over the past 10 years to measure the quality of functional performance testing and control stability of patients following ACL reconstruction. However this study found that the measurement of functional performance following ACL reconstruction consisting of a one-leg hop for a set distance or a combination of different hops using limb symmetry index (LSI) was a main outcome parameter of several studies. A more extensive series of tests is suggested to measure both the quantitative and qualitative aspects of functional performance after the ACL reconstruction. The KOOS and the IKDC questionnaires are both measures that are increasingly being used for ACL reconstruction throughout the last decade.

Lower Limb Symmetry: Comparison of Muscular Power Between Dominant and Nondominant Legs in Healthy Young Adults Associated With Single-Leg-Dominant Sports

“…Barber et al 3 introduced the limb symmetry index (LSI), which remains a commonly used tool for assessing whether muscle power through hop performance is normal. 1 , 38 In the study by Barber et al, 3 90% of the participants (nonathletes) had an LSI of less than 15%, which was considered normal. Based on these results, we suggest that a difference of less than 15% between lower extremities indicates muscular power leg symmetry in our population.…”

“…In our study we used a specific protocol for the single-leg squat jump test, which has been validated as a reliable tool for evaluating muscular leg power. 1 , 22 , 23 , 33 , 38 …”

“…Vertical height jump was assessed through the single-leg squat jump test 1 , 8 , 12 , 22 , 23 , 33 , 40 over an arithmetic platform (ie, a jumping platform with the capacity to measure flight height) as described by Dallas et al 12 modified from the Bosco et al 7 jump protocol. Each participant performed the jump test over a switch mat (Ergo Tester; Globus), which indirectly calculated the flight height of each single jump by using the flight time and the acceleration of gravity, with the following formula: h = ( tf 2 × g × 8) −1 , where h is height, tf is flight time, and g is the acceleration of gravity.…”

Interdisziplinäre Beurteilungskriterien für die Rehabilitation nach Verletzungen an der unteren Extremität: Ein funktionsbasierter Return-to-Activity Algorithmus

“…Andere Arbeitsgruppen haben sich bereits mit der Notwendigkeit einer qualitativen Beurteilung der funktionellen Beinachse beschäftigt [44,45]. Dabei gilt es nicht nur die Bewegungsqualität der betroffenen Seite zu evaluieren, denn Auffälligkeiten, auch auf der gesunden Seite, gelten als Risikofaktoren für Verletzungen [39].…”

How does functionality proceed in ACL reconstructed subjects? Proceeding of functional performance from pre- to six months post-ACL reconstruction

“…Due to the ACL tear, the injured leg as well as the uninjured leg can get influenced, resulting in a pathologic asymmetry level between the legs [16, 29]. However, it seems that task-specific symmetry levels in static and dynamic situations exist.…”