Measures of Agility and Single-Legged Balance as Clinical Assessments in Patients With Anterior Cruciate Ligament Reconstruction and Healthy Individuals

Abstract

Context Current clinical assessments used for patients with anterior cruciate ligament reconstruction (ACLR) may not enable clinicians to properly identify functional deficits that have been found in laboratory studies. Establishing muscular-function assessments, through agility and balance tasks, that can properly differentiate individuals with ACLR from healthy, active individuals may permit clinicians to detect deficits that increase the risk for poor outcomes. Objective To compare lower extremity agility and balance between patients with ACLR and participants serving as healthy controls. Design Case-control study. Setting Controlled laboratory. Patients or Other Participants A total of 47 volunteers in 2 groups, ACLR (9 males, 11 females; age = 23.28 ± 5.61 years, height = 173.52 ± 8.89 cm, mass = 70.67 ± 8.89 kg) and control (13 males, 12 females; age = 23.00 ± 6.44, height = 172.50 ± 9.24, mass = 69.81 ± 10.87 kg). Main Outcome Measure(s) Participants performed 3 timed agility tasks: Agility T Test, 17-hop test, and mat-hopping test. Balance was assessed in single-legged (SL) stance in 3 positions (straight knee, bent knee, squat) on 2 surfaces (firm, foam) with the participants' eyes open or closed for 10-second trials. Agility tasks were measured for time to completion. Eyes-open balance tasks were measured using center-of-pressure average velocity, and eyes-closed balance tasks were measured using the Balance Error Scoring System. Results For the Agility T Test, the ACLR group had slower times than the control group (P = .05). Times on the Agility T Test demonstrated moderate to strong positive relationships for unipedal measures of agility. The ACLR group had greater center-of-pressure average velocity in the SL bent-knee position than the control group. No differences were found between groups for the SL straight-knee and SL-squat balance tasks (P > .05). No differences in errors were present between groups for the eyes-closed balance tasks (P > .05). Conclusions The ACLR group demonstrated slower bipedal agility times and decreased postural stability when assessed in an SL bent-knee position compared with the control group.

Single- Versus Dual-Task Functional Movement Paradigms: A Biomechanical Analysis

“…Biomechanically assessing functional movement may allow for prediction and prevention of musculoskeletal injury [1][2][3] and is useful to assess return to sport readiness. 4,5 Previous work has thoroughly examined kinematic and kinetic outcomes during landing, [6][7][8][9] hopping, 5,10 and cutting 11,12 assessments without any cognitive loading. Functional movement studies are often conducted in quiet, controlled laboratory spaces in order to minimize distractions and optimize the participant's motor performance.…”

Functional Cortical Connectivity Related to Postural Control in Patients Six Weeks After Anterior Cruciate Ligament Reconstruction

“…Based on visual observations, patients largely preferred a straight leg stance position with nearly full extension of their weight-bearing limb. As previously found, a straight-knee single leg stance paradigm may lack sensitivity to demonstrate decreased postural stability in patients after ACLR, whereas bent-knee single leg stances were able to distinguish postural performance of patients and controls (Kirsch et al, 2019).…”

Anterior Cruciate Ligament Reconstruction Return-to-Sport Decision-Making: A Scoping Review

“…Outcomes of T-Test Agility conducted over multiple timepoints resulted in significant improvements for ACL-R athletes 16 , 40 ; however, ACL-R athletes performed significantly worse than HCG. 24 When used to assess LSI, T-Test Agility could not determine side-to-side differences. 32 Similarly, Pro-Agility results improved significantly between trials but did not identify significant LSI.…”