Functional performance tests as indicators of returning to sports after anterior cruciate ligament reconstruction

Jang, Suhyun; Kim, Jin Goo; Ha, Jeong Ku; Wang, Bae Gun; Yang, Sang Jin

doi:10.1016/j.knee.2013.08.017

Cited by 57 publications

(55 citation statements)

References 37 publications

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“…The same AGA survey confirmed the trend reported by Barber-Westin and Noyes, identifying ROM, the Lachman test and the pivot shift test as the most widely used objective criteria, and finding a surprisingly limited use of validated clinical scales (36). The rationale for the use of such scales is summarised by the study of Jang et al (37), who noted significantly worse muscle strength and rotational stability in athletes who were not able to return to sports activity. The trends and evidence here reported certainly highlight the need for precise objective measurement criteria, and future efforts should therefore be focused on the improvement or development of tools designed to measure and quantify patient performance.…”

Section: Return-to-sport Criteriasupporting

confidence: 71%

Return to sport after ACL reconstruction: how, when and why? A narrative review of current evidence

Zaffagnini

Grassi

Serra

et al. 2015

jts

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Allowing a patient to return to sport and unrestricted physical activity after ACL injury and reconstruction is one of the most challenging and difficult decisions an orthopaedic surgeon has to make. Indeed, many factors have to be taken into account before it can be considered safe for a patients to load a reconstructed knee. The current literature contains plenty of studies aimed at evaluating return to sport, and the factors that may affect or predict this outcome, e.g. intrinsic factors like genetics, biology, type of lesion, anatomical features, motivation and psychology, and extrinsic factors such as graft type, surgical technique, rehabilitation protocols, and biological support. It is possible that awareness of these issues could help the clinician to optimise outcomes, and possibly avoid failures too, although as yet no universal criteria for resuming sport have been produced.

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Section: Return-to-sport Criteriasupporting

confidence: 71%

Return to sport after ACL reconstruction: how, when and why? A narrative review of current evidence

Zaffagnini

Grassi

Serra

et al. 2015

jts

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“…There are a lot of studies that aim to assess the ability of a patient to progress through the end stages of rehabilitation after ACL reconstruction [19-22]. However, it is very difficult to obtain safe and objective markers during the initial phases.…”

Section: Discussionmentioning

confidence: 99%

Assessment of functional impairment after knee anterior cruciate ligament reconstruction using cardiorespiratory parameters: a cross-sectional study

Andrade

Lira

Vancini

et al. 2014

BMC Musculoskelet Disord

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BackgroundA dynamic sub-maximum exercise with the same absolute intensity, performed with different muscle groups, may present exacerbated cardiorespiratory responses. Therefore, cardiorespiratory responses to unilateral exercise may identify bilateral differences. The purpose of this study was to verify whether the cardiorespiratory responses to lower limb exercise display counter-lateral differences, and if they could be used to assist athletes and health professionals involved in rehabilitation.MethodsNine individuals participated in this cross-sectional study. They had been treated in a private rehabilitation clinic and submitted to intra-articular reconstruction of the anterior cruciate ligament. The cycling exercise with the same sub-maximal intensity and with one lower limb was used to gather data. Cardiorespiratory responses to exercise were compared between exercises performed with the involved and uninvolved limb after five minutes of exercise.ResultsCardiorespiratory responses to exercise performed with the involved limb presented higher values after five minutes of cycling: oxygen uptake (+7%), carbon dioxide production (+10%), minute ventilation (+20%), breathing frequency (+19%), ventilatory equivalent for oxygen (+14%), end-tidal pressure of O2 oxygen (+4%), end-tidal pressure of O2 carbon dioxide (-9%) and heart rate (+9%).ConclusionsThe exacerbated responses, including increase of the ventilatory equivalent and decrease of end-tidal pressure of carbon dioxide, indicate that this exercise protocol may be useful in the characterization of the functional deficit of the surgical limb during rehabilitation.

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“…Three field-based testing protocols have commonly been adopted [34,38,39,43,48]. These includes the shuttle run, co-contraction, and carioca tests.…”

Section: Field-based Assessmentsmentioning

confidence: 99%

“…However, it should be acknowledged that the isokinetic testing modes used were concentric only [38,43], and eccentric modes of contraction (for both the quadriceps and hamstrings) may be more relevant to CoD tasks. Other studies advocated that these tests were sensitive to distinguish athletes' readiness to return to sports activity [34,48]. Keays et al [38] observed that ACLr patients improved their time in the shuttle run, co-contraction and carioca tests by 10, 17, and 23%, respectively, at 6-month post-surgery compared to pre-surgery values.…”

Section: Field-based Assessmentsmentioning

confidence: 99%

Change of Direction Assessment Following Anterior Cruciate Ligament Reconstruction: A Review of Current Practice and Considerations to Enhance Practical Application

et al. 2019

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Change of direction (CoD) has been indicated as a key mechanism in the occurrence of anterior cruciate ligament (ACL) injury during invasion sports. Despite these associations, assessments of knee function in athletic populations at the time of return to sport following ACL reconstruction (ACLr) have often focused on strength and single-leg hop tests, with a paucity of evidence to describe the CoD characteristics. Therefore, the aim of this narrative review was to describe the movement strategies exhibited following ACLr during CoD tasks and to critically analyze the range of tests that have been used. Specifically, we examined their ability to identify between-limb deficits and individuals who display a heightened risk of secondary injury and/or reductions in their level of pre-injury performance. MEDLINE, PubMed and SPORT Discuss databases were used and 13 articles were identified that met the inclusion criteria. Examination of the available literature indicates that current field-based practices are not representative of relevant sport demands and are unable to effectively assess knee function following ACLr. Laboratory-based studies have identified residual deficits and altered movement strategies at the time of return to sport, and this in part may be related to risk of re-injury. However, these assessments exhibit inherent limitations and are not practically viable for monitoring progress during rehabilitation. Consequently, alternative solutions that are more-aligned with the multitude of factors occurring during CoD maneuvers in chaotic sports environments are warranted to allow practitioners to 'bridge the gap' between the laboratory and the sports field/court. This approach may facilitate a more informed decision-making process with the end goal being, a heightened 'return to performance' and a lower risk of re-injury.

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Functional performance tests as indicators of returning to sports after anterior cruciate ligament reconstruction

Cited by 57 publications

References 37 publications

Return to sport after ACL reconstruction: how, when and why? A narrative review of current evidence

Return to sport after ACL reconstruction: how, when and why? A narrative review of current evidence

Assessment of functional impairment after knee anterior cruciate ligament reconstruction using cardiorespiratory parameters: a cross-sectional study

Change of Direction Assessment Following Anterior Cruciate Ligament Reconstruction: A Review of Current Practice and Considerations to Enhance Practical Application

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