Impact of quadriceps strengthening on response to fatiguing exercise following ACL reconstruction

Kuenze, Christopher; Eltoukhy, Moataz; Kelly, Adam; Kim, Chang Young

doi:10.1016/j.jsams.2016.04.015

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…6,19,34,36,50,58,59 For >18 months after ACLR, moderate evidence (7 LR studies, heterogeneous) with a small effect size showed that ACLR limbs had lower quadriceps strength when compared with matched control limbs (SMD, -0.38; 95% CI, -0.79 to 0.03; I 2 ¼ 76%) (Figure 2). 7,11,25,26,29,42,48 It was seen that 1 study was causing the heterogeneity. 48 On removing this study, strong evidence (6 LR studies, homogeneous) with a moderate effect size showed that ACLR limbs had lower quadriceps strength when compared with matched control limbs (SMD, -0.60; 95% CI, -0.83 to -0.37; I 2 ¼ 29%).…”

Section: Quadriceps Strength In the Injured Limb For Aclr Compared With Matched Controlsmentioning

confidence: 99%

“…19,34,36,50,58 For >18 months after ACLR, moderate evidence (4 LR studies, heterogeneous) showed that quadriceps strength was similar in ACLR and matched control limbs (SMD, -0.24; 95% CI, -1.13 to 0.66; I 2 ¼ 88%). 7,25,26,48 It was seen that 1 study was causing the heterogeneity. 48 On removing this study, only 3 studies remained, so pooled analyses were not performed.…”

Section: Quadriceps Strength In the Injured Limb For Aclr Compared With Matched Controlsmentioning

confidence: 99%

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Quadriceps Strength After Anterior Cruciate Ligament Reconstruction Compared With Uninjured Matched Controls: A Systematic Review and Meta-analysis

Brown

Marinko

LaValley

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: The limb symmetry index may overestimate the recovery of quadriceps muscle strength after anterior cruciate ligament reconstruction. Comparison of individuals who have had anterior cruciate ligament reconstruction with age-, sex-, and activity-matched individuals might be more appropriate to guide rehabilitation interventions. Purpose: To compare the quadriceps strength between the injured limb of people with anterior cruciate ligament reconstruction and the limb of an age-, sex-, and activity-matched control group. Study Design: Systematic review; Level of evidence, 3. Methods: MEDLINE, CINAHL, EMBASE, SCOPUS, and SPORTDiscus were searched between inception and April 2019. Studies were included if they reported the peak quadriceps strength for persons with anterior cruciate ligament reconstruction and age-, sex-, and activity-matched control groups measured using isometric or isokinetic dynamometry. Risk of bias was assessed, and meta-analyses and metaregression (for effect of time since surgery) were performed. Results: A total of 2759 studies were identified and 21 were included for analyses. Quadriceps strength was lower in the limbs with anterior cruciate ligament reconstruction compared with the limb from matched controls within 6 months of anterior cruciate ligament reconstruction (standardized mean difference [SMD], –1.42; 95% CI, –1.62 to –1.23), 6 to 18 months after anterior cruciate ligament reconstruction (SMD, –0.92; 95% CI, –1.18 to –0.66), and >18 to 48 months after anterior cruciate ligament reconstruction (SMD, –0.38; 95% CI, –0.79 to 0.03). Results of the metaregression were significant, with the difference between anterior cruciate ligament reconstruction and matched controls decreasing with time since surgery ( P < .001). Conclusion: In people with anterior cruciate ligament reconstruction, the injured limb had lower quadriceps strength compared with the limb of age-, sex-, and activity-matched controls up to 4 years after surgery. Clinicians should consider comparison with matched cohorts for return to sports decision making.

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Section: Quadriceps Strength In the Injured Limb For Aclr Compared With Matched Controlsmentioning

confidence: 99%

Section: Quadriceps Strength In the Injured Limb For Aclr Compared With Matched Controlsmentioning

confidence: 99%

Quadriceps Strength After Anterior Cruciate Ligament Reconstruction Compared With Uninjured Matched Controls: A Systematic Review and Meta-analysis

Brown

Marinko

LaValley

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…The program consisted of 4 supervised and 10 home-based exercise sessions, for a total of 14 exercise sessions. 19,34 In all cases, the first day of the intervention was scheduled as a supervised exercise session to ensure proper technique for both supervised and home-based exercise sessions. After completing the initial supervised exercise session, participants were scheduled for 3 more supervised exercise sessions over the following 13 days.…”

Section: Cryotherapy-facilitated Quadriceps-strengthening Interventionmentioning

confidence: 99%

“…The number of repetitions and resistance used for each supervised and home-based exercise were progressed by the athletic trainers based on perceived difficulty and participant-reported fatigue throughout the supervised sessions. 34 Daily home treatments were Abbreviation: NA, not applicable. monitored using a treatment log, which was reviewed at each supervised exercise session.…”

Section: Cryotherapy-facilitated Quadriceps-strengthening Interventionmentioning

confidence: 99%

Unilateral Quadriceps Strengthening With Disinhibitory Cryotherapy and Quadriceps Symmetry After Anterior Cruciate Ligament Reconstruction

Kuenze

Kelly

Jun

et al. 2017

Journal of Athletic Training

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Context: The effect of unilateral cryotherapy-facilitated rehabilitation exercise on involved-limb quadriceps function and limb symmetry in individuals with quadriceps dysfunction after anterior cruciate ligament reconstruction (ACLR) remains unclear.Objective: To measure the effect of a 2-week unilateral cryotherapy-facilitated quadriceps-strengthening program on knee-extension strength and quadriceps central activation ratio (CAR) in participants with ACLR.Design: Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: A total of 10 volunteers with unilateral ACLR (1 man, 9 women; age ¼ 21.0 6 2.8 years, height ¼ 164.6 6 5.0 cm, mass ¼ 64.0 6 6.1 kg, body mass index ¼ 23.7 6 2.7 kg/m 2 ) and 10 healthy volunteers serving as control participants (1 man, 9 women; age ¼ 20.8 6 2.5 years, height ¼ 169.1 6 6.2 cm, mass ¼ 61.1 6 6.4 kg, body mass index ¼ 21.4 6 2.3 kg/m 2 ) participated. Intervention(s): Participants with ACLR completed a 2-week unilateral cryotherapy-facilitated quadriceps-strengthening intervention.Main Outcome Measure(s): Bilateral normalized kneeextension maximal voluntary isometric contraction (MVIC) torque (Nm/kg) and quadriceps CAR (%) were assessed preintervention and postintervention. Limb symmetry index (LSI) was calculated at preintervention and postintervention testing. Preintervention between-groups differences in unilateral quadriceps function and LSI were evaluated using independentsamples t tests. Preintervention-to-postintervention differences in quadriceps function were evaluated using paired-samples t tests. Conclusions: Two weeks of cryotherapy-facilitated exercise may improve involved-limb quadriceps function while preserving between-limbs symmetry in patients with a history of ACLR.Key Words: disinhibitory modalities, quadriceps strength, quadriceps central activation ratio, limb symmetry index, crosseducation Key PointsA 2-week cryotherapy-facilitated strengthening program may improve involved-limb quadriceps function and preserve between-limbs symmetry in patients with a history of anterior cruciate ligament reconstruction. Clinicians should consider using this approach when treating patients with persistent quadriceps weakness during recovery from anterior cruciate ligament reconstruction.

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ISB clinical biomechanics award winner 2019: Knee extensor fatigue resistance in individuals following anterior cruciate ligament reconstruction

Bodkin

Weltman

Hart

2021

Clinical Biomechanics

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Impact of quadriceps strengthening on response to fatiguing exercise following ACL reconstruction

Cited by 6 publications

References 32 publications

Quadriceps Strength After Anterior Cruciate Ligament Reconstruction Compared With Uninjured Matched Controls: A Systematic Review and Meta-analysis

Quadriceps Strength After Anterior Cruciate Ligament Reconstruction Compared With Uninjured Matched Controls: A Systematic Review and Meta-analysis

Unilateral Quadriceps Strengthening With Disinhibitory Cryotherapy and Quadriceps Symmetry After Anterior Cruciate Ligament Reconstruction

ISB clinical biomechanics award winner 2019: Knee extensor fatigue resistance in individuals following anterior cruciate ligament reconstruction

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