Funktionelle Tests als Entscheidungskriterium für die Rückkehr von Spielsportlern nach einer Ruptur des vorderen Kreuzbandes

Abstract

A rupture of the anterior cruciate ligament (ACL) represents a severe injury in game sports, which is time and cost-intensive for athletes and clubs alike. As the lower extremities are subjected to multiple forms of strain and high demands are placed on them, athletes in games like soccer are affected more often than others. The point of return-to-play after such severe injuries is often preceded by long periods of rehabilitation. However, these periods often vary strongly. Multiple approaches are being discussed to estimate the point of return-to-play using functional test procedures. However, no general consensus has been reached regarding the relevant parameters, available test procedures and interpretation of test results. Based on the requirement profile of soccer as a game sport, this review evaluates functional tests regarding the requirements strength, speed, agility, and movement quality as a coordinative feature. In addition to tests regarding individual forms of strain, this review also discusses combined test protocols. It describes performance variants and scientific quality criteria as well as the potential for practical implementation. While jumps can detect side-to-side asymmetries only through additional equipment such as force plates or markers, hop tests are more suitable for implementation and allow for an easier assessment of side-to-side asymmetries. Although several combined test protocols exist, none of them measures the entire requirement profile for games sports. To decrease the number of re-injuries after ACL rupture, a combined test protocol with a selection of the described scientifically reliable functional tests should be created and implemented as a return-to-competition guideline as well as pre-injury screening prior and during the season.

Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group

“…The RTS process should be considered as a progressive course throughout the patient's rehabilitation, taking into account the restoration of biological knee health according to the chosen treatment option, the targeted sport, and the desired level of performance, as well as concomitant knee injuries and psychological readiness [4, 5, 10, 17, 19, 20, 24, 46, 55, 76, 78]. The process should be divided into phases, including specific clinical and functional milestones that are required to be met before progression to the next phase [4, 5, 69].…”

The Reliability of Common Functional Performance Tests within an Experimental Test Battery for the Lower Extremities

“…However, other parameters affect the reliability analysis and were therefore included in this study: the coefficient of variation (CV) for the extent of variability, defined as the ratio of the SD to the mean (CV = SD/Mean × 100); the standard error of measurement (SEM) for the effect of measurement error, defined as the SD of an individual's repeated measurements (SEM = SD × √ 1 − ICC); the smallest real difference (SRD), defined as a measure of sensitivity to change (SRD = 1.96 × √ 2 × SEM) [42,43]. To assess the magnitude of the reliability analysis, the threshold values were considered as follows: poor (<0.5), moderate (0.50-0.75), good (0.75-0.90), and excellent (>0.90) for the ICC [44]; unacceptable (<0.5), poor (0.5-0.6), questionable (0.6-0.7), acceptable (0.7-0.8), good (0.8-0.9), and excellent (>0.90) for the Cronbach's α [45]; not acceptable (>30), acceptable (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), good (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and very good (<10) for the CV [46]; perfectly reliable (equal to 0) and completely unreliable (equal to the SD) for the SEM [46]; acceptable (<30%) for the SRD [47]. Finally, for the analysis of variance of the dependent variables, repeated measures ANOVA (p < 0.05) was used separately to compare differences in mean scores between the two testing sessions (T1 and T2).…”

“…In sports therapy, functional test batteries are widely used to assess sport-specific functional performance [ 2 , 4 ], to establish prevention strategies (such as pre-injury screenings) for anterior cruciate ligament injury (ACL-I) [ 5 , 6 ], and to plan specific training interventions for the lower extremities [ 7 , 8 , 9 , 10 ]. Furthermore, they are regularly used in monitoring and decision-making processes of rehabilitation after ACL-I, for return-to-sport clearance, and for movement quality assessments [ 4 , 11 , 12 , 13 , 14 ].…”

Changes After a Conventional vs. an Alternative Therapy Program on Physical, Psychological, and Injury-Related Parameters in Male Youth Soccer Players With Patellar Tendinopathy During Return to Competition

“…Although previous studies (1,5,7,17,44) described various therapy protocols as successful in treating PT, they focused on injury-related rather than performance-related variables. However, Wilke et al (43) highlighted that the latter are crucial in assessing the effectiveness of a treatment on return to competition. In their review, they described that without performance-determining factors corresponding to the demands of competition, no reliable statement can be made about an athlete's readiness to return to competition.…”