Optimising the Late-Stage Rehabilitation and Return-to-Sport Training and Testing Process After ACL Reconstruction

Buckthorpe, Matthew

doi:10.1007/s40279-019-01102-z

Cited by 129 publications

(155 citation statements)

References 138 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…The return to sport/return to performance transition after ACL injury is a multifactorial process characterized by complexity and many uncertainties (Buckthorpe, 2019;Burgi et al, 2019). It is of critical importance after ACLR surgery to ensure tissues have had sufficient time to heal, a process that often requires more time than is allotted by return to sport timelines (Nagelli and Hewett, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…However, there are few pragmatic and concrete measures of healing, and time from surgery has little bearing on functional capacities after ACL injury (Barber-Westin and Noyes, 2011; Grindem et al, 2016;Burgi et al, 2019;Cristiani et al, 2019). Thus, objective neuromuscular testing is recommended after ACL injury to evaluate functional milestones alongside a carefully planned and progressive return to sport training plan (Myer et al, 2006;Grindem et al, 2016;Buckthorpe, 2019). This seems especially important for alpine ski racers with ACL injury given the high risk for traumatic injury (Flørenes et al, 2009;Bere et al, 2014), the high lower body strength and work capacity demands involved in ski racing (Berg et al, 1995), the frequency FIGURE 8 | Recovery of the isometric knee extensor/knee flexor maximum torque (A), rate of torque development-RTD (B), leg press maximum force (C), and leg press rate of force development-RFD (D) in the post-injury period.…”

Section: Discussionmentioning

confidence: 99%

“…It is estimated that between 50 and 60% of athletes who sustain an ACL injury will return to competitive sport (Ardern et al, 2014;, while the proportion of alpine skiers returning to competitive sport may be even higher (Haida et al, 2016). Athletes who undergo ACLR surgery require extensive rehabilitation and training to restore knee joint function and objectively determined functional criteria are recommended to guide the return to sport transition to safeguard against secondary ACL injury (Buckthorpe, 2019). However, sports medicine practitioners and trainers often rely solely on time-based criteria to determine when an athlete is sufficiently prepared to return to sport (Barber-Westin and Noyes, 2011), and it has been shown that only a small fraction of ACLR athletes (23%) pass objectively determined functional criteria prior to return to sport .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Monitoring the Return to Sport Transition After ACL Injury: An Alpine Ski Racing Case Study

Jordan

Morris

Lane

et al. 2020

Front. Sports Act. Living

View full text Add to dashboard Cite

Alpine ski racing is an extreme sport and ski racers are at high risk for ACL injury. ACL injury impairs neuromuscular function and psychological readiness putting alpine skiers with ACL injury at high risk for ACL reinjury. Consequently, return to sport training and testing protocols are recommended to safeguard ACL injured athletes against reinjury. The aim of this paper was to present a real-world example of a return to sport training plan for a female elite alpine ski racer who sustained an ACL injury that was supported by an interdisciplinary performance team (IPT) alongside neuromuscular testing and athlete monitoring. A multi-faceted return to sport training plan was developed by the IPT shortly after the injury event that accounted for the logistics, healing, psychological readiness, functional milestones, work capacity and progression to support the return to sport/return to performance transition. Neuromuscular testing was conducted at several timepoints post-injury. Importantly, numerous pre-injury tests provided a baseline for comparison throughout the recovery process. Movement competencies and neuromuscular function were assessed, including an evaluation of muscle properties (e.g., the force-velocity and force-length relationships) to assist the IPT in pinpointing trainable deficits and managing the complexities of the return to sport transition. While the athlete returned to snow 7 months post-injury, presenting with interlimb asymmetries below 10%, functional and strength deficits persisted up to 18 months post-injury. More research is required to establish a valid return to sport protocol for alpine ski racers with ACL injury to safeguard against the high risk for ACL reinjury.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Monitoring the Return to Sport Transition After ACL Injury: An Alpine Ski Racing Case Study

Jordan

Morris

Lane

et al. 2020

Front. Sports Act. Living

View full text Add to dashboard Cite

show abstract

“…Some researchers considered that at that time, open techniques, the exclusive use of bone-patellar tendon-bone and a very long period of immobilization with a brace or cast after the operation may have seriously affected the surgical results of combined reconstruction [11]. In recent years, the rapid development of arthroscopically assisted techniques, the various choices of intra-articular grafts and accelerated standard rehabilitation have resulted in a radical change in reconstruction techniques [14].…”

Section: Introductionmentioning

confidence: 99%

Surgical intra- and extra-articular anterior cruciate ligament reconstruction: a meta-analysis

Cheng

Liu

Zhou

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background: It is still controversial whether the combination of anterior cruciate ligament (ACL) reconstruction and extra-articular reconstruction (EAR) have good clinical efficacy. This meta-analysis aims to compare the clinical effectiveness of ACL reconstruction and combined reconstruction. Methods: Electronic databases, including Medline/PubMed, Embase and the Cochrane Library, were systematically searched to identify targeted studies. A meta-analysis aims to pool the outcome estimates of interest, such as the Lysholm, International Knee Documentation Committee (IKDC) and Tegner scores and the results from the KT-1000/2000 arthrometer test, the Lachman test and the pivot shift test. Results : Twelve studies involving 1146 knees were identified. Compared with single ACL reconstruction, combined reconstruction had better results for a pivot shift of grade 1 (relative ratio [RR] = 0.88, 95% CI: 0.83-0.94) and grade 2 (RR = 0.95, 95% CI: 0.91-0.99) rather than grade 3 (RR = 0.98, 95% CI: 0.90-1.06) and no statistically significant difference for both Lachman grade 1 (RR = 0.96, 95% CI: 0.89-1.05) and grade 2 (RR = 0.96, 95% CI: 0.90-1.03). Combined reconstruction resulted in significant improvements on the instrumented joint laxity test when considering a failure standard of more than 5 mm (a side-to-side arthrometric difference) (RR = 0.94, 95% CI: 0.89-0.98) rather than 3 mm (RR = 0.94, 95% CI: 0.86-1.03). Moreover, combined reconstruction increased the IKDC score at the 12-month (weighted mean difference [WMD] = -6.38, 95% CI: -9.66 to -3.10), 24-month (WMD = -5.60, 95% CI: -8.54 to -2.66) and 36-month follow-ups (WMD = -4.71, 95% CI: -7.59 to -1.83) and the Tegner score at the 36-month follow-up (WMD = -0.53, 95% CI: -0.97 to -0.09), but it did not increase the Lysholm score at the 36-month follow-up (WMD = -0.84, 95% CI: -2.02 to 0.34). Conclusion : With the advances in reconstruction techniques, combined reconstructions were found to be effective in improving rotational stability and to lead to good functional scores. However, obviously, the combined reconstruction technique is more time-consuming and requires an additional incision, which is not suitable for all ACL-deficient patients. Therefore, programs should be personalized and customized for the specific situation of each patient.

show abstract

“…Am Ende einer Rehabilitation steht die Verbesserung der Zielfunktionen im Vordergrund. Neben der optimalen Wiederherstellung der neuromuskulären und kardiozirkulatorischen Leistungsfähigkeit ist die Bewegungsqualität unter Berücksichtigung des sportartspezifischen Anforderungsprofils besonders wichtig [9] [43]. Hierzu sind regelmäßige trainingsbegleitende Verlaufsdiagnostiken sowie eine adäquate Belastungserprobung durch Testprotokolle unabdingbar [10] [27].…”

unclassified

Multiligamentäre Kniegelenkverletzungen – Spätphase der Reha und Return to Sport

Praetorius¹,

Raeder²,

Keller³

et al. 2020

Sportphysio

View full text Add to dashboard Cite

show abstract

Optimising the Late-Stage Rehabilitation and Return-to-Sport Training and Testing Process After ACL Reconstruction

Cited by 129 publications

References 138 publications

Monitoring the Return to Sport Transition After ACL Injury: An Alpine Ski Racing Case Study

Monitoring the Return to Sport Transition After ACL Injury: An Alpine Ski Racing Case Study

Surgical intra- and extra-articular anterior cruciate ligament reconstruction: a meta-analysis

Multiligamentäre Kniegelenkverletzungen – Spätphase der Reha und Return to Sport

Contact Info

Product

Resources

About