Open Versus Closed Chain Kinetic Exercises After Anterior Cruciate Ligament Reconstruction

Abstract

We conducted a prospective, randomized study of open and closed kinetic chain exercises during accelerated rehabilitation after anterior cruciate ligament reconstruction to determine if closed kinetic chain exercises are safe and if they offer any advantages over conventional rehabilitation. The closed kinetic chain group used a length of elastic tubing, the Sport Cord, to perform weightbearing exercises and the open kinetic chain group used conventional physical therapy equipment. Results are reported with a minimum 1-year followup (mean, 19 months). Pre- and postoperative evaluation included the Lysholm knee function scoring scale, Tegner activity rating scale and KT-1000 arthrometer measurements. Overall, stability was restored in over 90% of the knees. Preoperative patellofemoral pain was reduced significantly; 95% of the patients had a full range of motion. The closed kinetic chain group had lower mean KT-1000 arthrometer side-to-side differences, less patellofemoral pain, was generally more satisfied with the end result, and more often thought they returned to normal daily activities and sports sooner than expected. We concluded that closed kinetic chain exercises are safe and effective and offer some important advantages over open kinetic chain exercises. As a result of this study, we now use the closed kinetic chain protocol exclusively after anterior cruciate ligament reconstruction.

Chiropractic management of a postoperative complete anterior cruciate ligament rupture using a multimodal approach: a case report

“…This type of program was based on the findings of recent research. 5,6 Our patient was able to return to play with no complications following the 12-week program, which could be attributed to this type of rehabilitation protocol.…”

“…Arguments exist over effectiveness of accelerated vs decelerated programs, neuromuscular vs strength-based exercises, and open-vs closed-chain focused programs. 5,6 Based on current research, we decided that a postoperative program combining both neuromuscular and strength-based exercises in conjunction with specialized soft tissue techniques should be implemented in our treatment program. The purpose of this case study is to report on a patient who improved in recovery with functional rehabilitation, a program customized for the patient based on findings from functional evaluations, along with the addition of the following adjunctive therapies: Active Release Technique (ART), Graston Technique (GT), and Kinesio Taping (KT).…”

Asymmetries of Maximum Hand Grip-, Trunk Rotation and Extensor Strength of the Lower Extremities in Healthy Active Males

“…thus, the overall test results vary and also those considering leg preference. exercises in the closed-kinematic chain are more specific, functional and safe because of their complexity compared to exercises in the open-chain (4,13,28). those are often the preferred method in rehabilitation because they place less stress e.g.…”

“…those are often the preferred method in rehabilitation because they place less stress e.g. on the anterior cruciate ligament (4).…”

Análise da simetria em tarefas motoras em sujeitos submetidos à reconstrução do ligamento cruzado anterior

“…O agachamento é um exercício multiarticular clássico, classificado como sendo em cadeia cinética fechada (Wilk, Escamilla et al, 1996;Escamilla, Fleisig et al, 1998), que tem sido recomendado tanto para programas de musculação para membros inferiores quanto para programas de reabilitação após lesões (Shelbourne, Klootwyk et al, 1992;Bynum, Barrack et al, 1995). Como exercício, sabe-se que há um incremento da força da musculatura que envolve o quadril, a coxa e o tronco, os quais são músculos muito importantes para atividades como a corrida e o salto.…”