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García-Rodríguez P, Pecci J, Vázquez-González S, Pareja-Galeano H. Acute and Chronic Effects of Blood Flow Restriction Training in Physically Active Patients With Anterior Cruciate Ligament Reconstruction: A Systematic Review. Sports Health 2024; 16:820-828. [PMID: 37946502 PMCID: PMC11346237 DOI: 10.1177/19417381231208636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
CONTEXT Muscle atrophy and loss of knee function are common findings after anterior cruciate ligament (ACL) reconstruction. Rehabilitation through blood flow restriction (BFR) has gained clinical relevance when combined with low loads to improve these disorders in recent years. OBJECTIVE To evaluate the rehabilitation effectiveness of ACL reconstruction with the use of BFR on pain, functionality, strength, and muscle mass in physically active people. DATA SOURCES A search of PubMed, Web of Science, and MEDLINE was performed on March 31, 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. STUDY SELECTION Randomized clinical trials with active adults who underwent ACL surgery were included. They had to compare conventional treatments with the use of BFR, reporting values of pain, functionality, strength, or cross-sectional area (CSA). Articles whose participants presented concomitant injuries and whose intervention combined the use of BFR with treatments other than resistance training were excluded. STUDY DESIGN Systematic review. LEVEL OF EVIDENCE Level 2. DATA EXTRACTION Study design, population, cuff pressure, and main outcomes including strength, quadriceps CSA, pain, and functionality. RESULTS Six studies out of a total of 389 were included (152 participants; 90 men and 62 women). These included studies showed no differences on CSA or strength when comparing BFR training with high loads exercise. BFR has demonstrated improvements in knee functionality and pain compared with other interventions such as immobilization or high loads training. CONCLUSION The use of low loads combined with BFR improves pain, strength, functionality, and CSA. In addition, knee pain reduction and functionality are greater with BFR compared with the use of high loads or immobilization.
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Affiliation(s)
- Pere García-Rodríguez
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Madrid, Spain
| | - Javier Pecci
- Department of Physical Education and Sport, University of Seville, Seville, Spain
| | - Sergio Vázquez-González
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Madrid, Spain
- Rehabilitación Premium Madrid Clinic, Madrid, Spain
| | - Helios Pareja-Galeano
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, Madrid, Spain
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Tayfur B, Keneen Johnson A, Palmieri-Smith R. Changes in Quadriceps Rate of Torque Development After Anterior Cruciate Ligament Reconstruction and Association to Single-Leg Hop Distance. Sports Health 2024; 16:808-816. [PMID: 37873996 PMCID: PMC11346242 DOI: 10.1177/19417381231205295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Quadriceps neuromuscular function is negatively affected after anterior cruciate ligament reconstruction (ACLR). The specific effect that the ACLR has on the quadriceps femoris rate of force production and its impact on functional recovery is unknown. HYPOTHESIS The anterior cruciate ligament (ACL) limb would present persistent deficits in the rate of torque development (RTD), when compared with the non-ACL limb before ACLR until 9 months (9M) post-ACLR. STUDY DESIGN Prospective cohort study. LEVEL OF EVIDENCE Level 3. METHODS Twenty-eight participants performed quadriceps maximum voluntary isometric contractions (MVICs) before (PRE), at 5 months (5M) and at 9M after ACLR. Single-leg hop distance was also assessed at 9M. Quadriceps RTD was calculated at 50, 100, and 200 ms after the onset of torque production. Maximum RTD was also calculated. A 2 (limb) × 3 (time) repeated-measures analysis of variance was used for RTD50, RTD100, RTD200, and RTDmax. Linear regressions were used to evaluate the associations of MVIC and RTD values at 5M and 9M with single-leg hop distance at 9M. RESULTS The ACL limb had lower RTD values at all times compared with the non-ACL limb (P < 0.05). RTD of the ACL limb significantly decreased from PRE to 5M, and then recovered to PRE levels at 9M (P < 0.05). The non-ACL limb displayed no differences from baseline to either 5M or 9M. MVIC and RTD200 at 5M predicted (R2 = 0.313 and R2 = 0.262, respectively) single-leg hop distance at 9M, better than the strength and RTD at 9M (R2 = 0.235 and R2 = 0.128, respectively). CONCLUSION Quadriceps RTD is negatively affected after ACLR, and deficits may persist at the time of return to activity. Strength and RTD during recovery at 5M may predict more than 25% of the variance in single-leg hop distance at 9M, independently; hence, both provide important information to monitor functional recovery post-ACLR. CLINICAL RELEVANCE RTD should be measured to understand the changes in neuromuscular capacity after ACLR, and rehabilitation strategies that target quick force production, ie, quick muscle activation and functional tasks, should be implemented.
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Affiliation(s)
- Beyza Tayfur
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
- Orthopedic Rehabilitation and Biomechanics (ORB) Laboratory, University of Michigan, Ann Arbor, Michigan
| | - Alexa Keneen Johnson
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
- Orthopedic Rehabilitation and Biomechanics (ORB) Laboratory, University of Michigan, Ann Arbor, Michigan
| | - Riann Palmieri-Smith
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
- Orthopedic Rehabilitation and Biomechanics (ORB) Laboratory, University of Michigan, Ann Arbor, Michigan
- Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, Michigan
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Ripic Z, Letter M, Schoenwether B, Kaplan LD, Baraga MG, Costello Ii JP, Eskenazi J, Dennison M, Best TM, Signorile JF, Eltoukhy M. A hop testing alternative for functional performance following anterior cruciate ligament reconstruction. PLoS One 2024; 19:e0309003. [PMID: 39150940 PMCID: PMC11329148 DOI: 10.1371/journal.pone.0309003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 08/04/2024] [Indexed: 08/18/2024] Open
Abstract
The purpose of this work was to provide a simple method to determine reactive strength during the 6-meter timed hop test (6mTH) and evaluate its association with isokinetic peak torque in patients following anterior cruciate ligament reconstruction (ACLR). Twenty-nine ACLR patients who were at least four months from surgery were included in this analysis. Participants were brought into the laboratory on one occasion to complete functional testing. Quadriceps and hamstring isokinetic testing was completed bilaterally at 60, 180, and 300 deg∙s-1, using extension peak torque from each speed as the outcome measure. The 6mTH was completed bilaterally using a marker-based motion capture system, and reactive strength ratio (RSR) was calculated from the vertical velocity of the pelvis during the test. An adjustment in RSR was made using the velocity of the 6mTH test to account for different strategies employed across participants. Repeated measures correlations were used to determine associations among isokinetic and hop testing variables. A two-way mixed analysis of variance was used to determine differences in isokinetic and hop testing variables between operated and non-operated legs and across male and female participants. Moderate positive associations were found between RSR (and adjusted RSR) and isokinetic peak torque at all speeds (r = .527 to .577). Mean comparisons showed significant main effects for leg and sex. Patients showed significant deficits in their operated versus non-operated legs in all isokinetic and hop testing variables, yet only isokinetic peak torque and timed hop time showed significant differences across male and female groups. Preliminary results are promising but further development is needed to validate other accessible technologies available to calculate reactive strength during functional testing after ACLR. Pending these developments, the effects of movement strategies, demographics, and levels of participation on RSR can then be explored to translate this simple method to clinical environments.
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Affiliation(s)
- Zachary Ripic
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, United States of America
- Department of Orthopaedics, University of Miami Health System - Sports Medicine Institute, Coral Gables, FL, United States of America
| | - Michael Letter
- Department of Orthopaedics, University of Miami Health System - Sports Medicine Institute, Coral Gables, FL, United States of America
| | - Brandon Schoenwether
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, United States of America
| | - Lee D Kaplan
- Department of Orthopaedics, University of Miami Health System - Sports Medicine Institute, Coral Gables, FL, United States of America
| | - Michael G Baraga
- Department of Orthopaedics, University of Miami Health System - Sports Medicine Institute, Coral Gables, FL, United States of America
| | - Joseph P Costello Ii
- Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Jordan Eskenazi
- Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Molly Dennison
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, United States of America
| | - Thomas M Best
- Department of Orthopaedics, University of Miami Health System - Sports Medicine Institute, Coral Gables, FL, United States of America
| | - Joseph F Signorile
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, United States of America
| | - Moataz Eltoukhy
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, United States of America
- Department of Industrial and Systems Engineering, University of Miami, Coral Gables, FL, United States of America
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States of America
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Maestroni L, Turner A, Papadopoulos K, Pedley J, Sideris V, Read P. Single leg drop jump is affected by physical capacities in male soccer players following ACL reconstruction. SCI MED FOOTBALL 2024; 8:201-211. [PMID: 37314868 DOI: 10.1080/24733938.2023.2225481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
Single leg drop jump (SLDJ) assessment is commonly used during the later stages of rehabilitation to identify residual deficits in reactive strength but the effects of physical capacity on kinetic and kinematic variables in male soccer players following ACL reconstruction remain unknown. Isokinetic knee extension strength, kinematics from an inertial measurement unit 3D system and SLDJ performance variables and mechanics derived from a force plate were measured in 64 professional soccer players (24.7 ± 3.4 years) prior to return to sport (RTS). SLDJ between-limb differences was measured (part 1) and players were divided into tertiles based on isokinetic knee extension strength (weak, moderate and strong) and reactive strength index (RSI) (low, medium and high) (part 2). Moderate to large significant differences between the ACL reconstructed and uninjured limb in SLDJ performance (d = 0.92-1.05), kinetic (d = 0.62-0.71) and kinematic variables (d = 0.56) were evident. Stronger athletes jumped higher (p = 0.002; d = 0.85), produced greater concentric (p = 0.001; d = 0.85) and eccentric power (p = 0.002; d = 0.84). Similar findings were present for RSI, but the effects were larger (d = 1.52-3.84). Weaker players, and in particular those who had lower RSI, displayed landing mechanics indicative of a 'stiff' knee movement strategy. SLDJ performance, kinetic and kinematic differences were identified between-limbs in soccer players at the end of their rehabilitation following ACL reconstruction. Players with lower knee extension strength and RSI displayed reduced performance and kinetic strategies associated with increased injury risk.
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Affiliation(s)
- Luca Maestroni
- ReAct, Bergamo (BG), Italy
- London Sport Institute, School of Science and Technology, Middlesex University, London, UK
| | - Anthony Turner
- London Sport Institute, School of Science and Technology, Middlesex University, London, UK
| | | | - Jason Pedley
- Youth Physical Development Center, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Vasileios Sideris
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Paul Read
- Institute of Sport, Exercise and Health, London, UK
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
- Division of Surgery and Interventional Science, University College London, London, UK
- Faculty of Sport, Allied Health and Performance Sciences, St Marys University, Twickenham, UK
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Dauty M, Combes P, Gernigon M, Menu P, Crenn V, Daley P, Fouasson-Chailloux A. Difference of Knee Strength Recovery Between Revision and Primary ACL Reconstruction. Int J Sports Med 2024; 45:390-398. [PMID: 38267006 DOI: 10.1055/a-2253-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Different grafting procedures are available to restore knee stability after revision anterior cruciate ligament (ACL) reconstruction. We compared knee strength recovery between ACL revision surgery and primary reconstruction. One hundred and ten patients with ACL revision surgery were matched with 110 patients with primary reconstruction based on the graft procedure. The isokinetic knee strength had been assessed for the first 9 months post-surgery. Knee laxity, function, and activity score were also evaluated. Limb symmetry index for knee extensor and flexor strength was not different at 4-, 6- and 9-months post-surgery between revision surgery and primary reconstruction. These results depended on ipsilateral or contralateral graft choice. Ipsilateral hamstring tendon (HT) and contralateral bone-patellar-tendon-bone (BPTB) graft procedures were similar for a revision of a BPTB graft failure. Contralateral HT procedure was better than ipsilateral BPTB procedure for a revision of a HT graft failure. The early recovery of isokinetic knee strength after ACL revision surgery regardless of the HT or BPTB procedures, was similar to the recovery after primary ACL reconstruction with the same graft technique. These results apparently depended on a temporary quadriceps arthrogenic muscle inhibition and on a persistent donor site morbidity, concerning the new and the previous grafts, respectively.
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Affiliation(s)
- Marc Dauty
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France
- Service de Médecine du Sport, CHU Nantes, Nantes, France
- Institut Régional de Médecine du Sport, CHU Nantes, Nantes, France
| | - Philippe Combes
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France
| | - Marie Gernigon
- CIAMS, Université Paris-Saclay, Gif-sur-Yvette, France
- CIAMS, Université d'Orléans, Orleans, France
| | - Pierre Menu
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France
- Service de Médecine du Sport, CHU Nantes, Nantes, France
| | - Vincent Crenn
- Clinique Chirurgicale Orthopédique et Traumatologique, CHU Nantes, Nantes, France
| | - Pauline Daley
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France
- Service de Médecine du Sport, CHU Nantes, Nantes, France
| | - Alban Fouasson-Chailloux
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France
- Service de Médecine du Sport, CHU Nantes, Nantes, France
- Institut Régional de Médecine du Sport, CHU Nantes, Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, Nantes, France
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Babakhani F, Hatefi M, Balochi R. Is there a relationship between isometric hamstrings-to-quadriceps torque ratio and athletes' plyometric performance? PLoS One 2023; 18:e0294274. [PMID: 37972148 PMCID: PMC10653514 DOI: 10.1371/journal.pone.0294274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The application of the modified reactive strength index (RSImod) and isometric hamstrings to quadriceps (H:Q) torque ratio to monitoring the athletes' performance is well established, but their relationship to each other still remains unknown. Therefore, the purpose of this investigation was to clarify whether there is a relationship between RSImod and the isometric H:Q torque ratio. METHODS Twenty-one male recreational athletes (age, 24.89 ± 4.46 years; weight, 74.11 ± 8.66 kg; height, 179.78 ± 6.76 cm) volunteered to participate in this research. Their isometric H:Q torque ratio via hand-held dynamometer and jumping performance variables during the stop jump (STJ), double leg-drop vertical jump (DL-DVJ), and single leg-drop vertical jump (SL-DVJ) tasks were measured. Also, the RSImod was calculated by dividing the vertical jump height by the time to take-off. Pearson correlation coefficients were used to determine the relationship between the RSImod and jumping performance variables. RESULTS The result showed a significant strong positive relationship between the H:Q torque ratio and STJ performance based on the RSImod (p = .027, r = .724). Although, there was a moderate positive relationship between the H:Q torque ratio and jumping height of the STJ task, but it wasn't statistically significant (p = .096, r = .588). Also, no significant relationship was found between the H:Q torque ratio and all jumping performance variables of the DL-DVJ and SL-DVJ tasks (p ≥ .05). CONCLUSION The current study exhibited that the isometric H:Q torque ratio correlates to STJ performance based on RSImod but not to SL-DVJ and DL-DVJ. Notably, the difference in results between jumping tasks can be attributed to the complexity of the movement, which means that the RSImod is probably related to other factors. Therefore, the isometric H:Q torque ratio used to monitor the athletes' performance couldn't independently represent the jumping performance that is determined by RSImod.
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Affiliation(s)
- Farideh Babakhani
- Department of Sport Injuries and Corrective Exercises, Faculty of Physical education, Allameh Tabataba’i University, Tehran, Iran
| | - Mohamadreza Hatefi
- Department of Sport Injuries and Corrective Exercises, Faculty of Physical education, Allameh Tabataba’i University, Tehran, Iran
| | - Ramin Balochi
- Department of Sport Injuries and Corrective Exercises, Faculty of Physical education, Allameh Tabataba’i University, Tehran, Iran
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Read PJ, Davies WT, Bishop C, McAuliffe S, Wilson MG, Turner AN. Residual Deficits in Reactive Strength After Anterior Cruciate Ligament Reconstruction in Soccer Players. J Athl Train 2023; 58:423-429. [PMID: 37523420 PMCID: PMC11220905 DOI: 10.4085/0169-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
CONTEXT Deficits in plyometric abilities are common after anterior cruciate ligament reconstruction (ACLR). Vertical rebound tasks may provide a targeted evaluation of knee function. OBJECTIVE To examine the utility of a vertical hop test for assessing function after ACLR and establishing factors associated with performance. DESIGN Cross-sectional study. SETTING Rehabilitation program. PATIENTS OR OTHER PARTICIPANTS Soccer players with a history of ACLR (n = 73) and matched control individuals (n = 195). MAIN OUTCOME MEASURE(S) The 10-second vertical hop test provided measures of jump height, the Reactive Strength Index (RSI), and asymmetry. We also examined possible predictors of hop performance, including single-legged vertical drop jump, isokinetic knee-extension strength, and the International Knee Documentation Committee questionnaire score. RESULTS Between-limbs differences were identified only for the ACLR group, and asymmetry scores increased in those with a history of ACLR (P < .001) compared with the control group. The single-legged vertical drop jump, RSI, and knee-extension torque were significant predictors of 10-second hop height (R2 = 20.1%) and RSI (R2 = 47.1%). CONCLUSIONS Vertical hop deficits were present after ACLR, even after participants completed a comprehensive rehabilitation program. This may have been due to reduced knee-extension and reactive strength. Vertical hop tests warrant inclusion as part of the return-to-sport test battery.
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Affiliation(s)
- Paul J. Read
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Vassis K, Kanellopoulos A, Spanos S, Kakolyri D, Loukopoulou A, Papanikolakou V, Aivaliotis D, Poulis I. Association Between Isokinetic Knee Strength Characteristics and Single-Leg Hop Performance In Healthy Young Participants. J Chiropr Med 2023; 22:27-34. [PMID: 36844986 PMCID: PMC9948001 DOI: 10.1016/j.jcm.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 05/04/2022] [Accepted: 05/26/2022] [Indexed: 10/16/2022] Open
Abstract
Objective The purpose of this study was to determine the extent to which the mean peak moment (MPM) of knee flexors and extensors could predict performance in a group of healthy individuals. Methods Eighty-four healthy individuals-32 men and 52 women (mean age, 22.1 ± 3 years; range, 18-35 years)-participated in this study. Isokinetic unilateral concentric knee flexor and extensor MPM was assessed isokinetically at angular velocities of 60°/s and 180°/s. Functional performance was assessed using the single hop of distance (SHD). Results Positive moderate to good statistically significant correlations (r = .636 to r = .673) were found between knee flexor and extensor MPM at 60°/s and 180°/s for the SHD test. Knee flexor and extensor MPMs are strong predictors for the SHD test at 60°/s and 180°/s (R2 = .40 to R2 = .45). Conclusion Knee flexor and extensor strength was substantially correlated with SHD.
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Affiliation(s)
- Konstantinos Vassis
- Human Performance and Rehabilitation Laboratory, University of Thessaly, Lamia, Greece
| | | | - Savvas Spanos
- Human Performance and Rehabilitation Laboratory, University of Thessaly, Lamia, Greece
- Faculty of Physiotherapy, University of Thessaly, Lamia, Greece
| | | | | | | | | | - Ioannis Poulis
- Human Performance and Rehabilitation Laboratory, University of Thessaly, Lamia, Greece
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Lem HW, Cheng SC, Chang HY, Hung MH, Yeh WL. Single leg drop jump performance identifies functional deficit in collegiate athletes who have returned to sports after ACL reconstruction: A case-control study. Medicine (Baltimore) 2022; 101:e31790. [PMID: 36626457 PMCID: PMC9750644 DOI: 10.1097/md.0000000000031790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Despite its apparent functional importance, there is a general lack of data in explosive strength in individuals recovering from an anterior cruciate ligament reconstruction (ACLR). Hence, we wonder if single leg drop jump (SLDJ) can be an effective testing since drop jump is a commonly used testing which rely on adequate development of explosive strength and stretch shortening cycle function. The purpose of this study was to determine if SLDJ test can identify functional deficit in collegiate athletes who have returned to sports (RTS) after ACLR when comparing it with the common return to sport testing. Nine collegiate athletes who had undergone a unilateral ACLR and returned to their primary sport with at least 10 months post-surgery were recruited and assigned into the injured group and compared with 9 matched non-injured athletes as the control group. Both groups underwent an identical battery testing in 1 session with the sequence of first modified star excursion balance test (SEBT), second single hop and bound test, third SLDJ and lastly 1 repetition maximum (1RM) single leg press. A 2-way mixed model analysis of variance showed that there is no significant interaction effect on common RTS testing which include modified SEBT, single hop and bound tests, and 1RM single leg press, but significant interaction effect on SLDJ jump height (P = .03), reactive strength index (P = .03) and mean propulsion force (P = .03). For the injured group, ACLR leg jump height (10.35 ± 2.71 cm) was significantly lower than non-ACLR leg (12.86 ± 3.51 cm) with a mean difference of 2.51 (95% confidence interval [CI]: 0.55-4.47). ACLR leg reactive strength index (0.29 ± 0.10 m/s) was significantly < non-ACLR leg (0.39 ± 0.16 m/s) with a mean difference of 0.1 (95% CI: 0.03-0.17) and ACLR leg mean propulsion force (1087.49 ± 287.26 N) was significantly < non-ACLR leg (1157.40 ± 299.80 N) with a mean difference of 69.91 (95% CI: 16.04 to 123.78). SLDJ was able to identify jump height, reactive strength and propulsion force deficit in the involved limb of collegiate athletes who have returned to sports after ACLR.
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Affiliation(s)
- Han Wei Lem
- MSc and MPE Dual Programme in International Sport Coaching Science, University of Physical Education, Budapest, Hungary
- MSc and MPE Dual Programme in International Sport Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Shih-Chung Cheng
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Hsiao-Yun Chang
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan, Taiwan
| | - Min-Hao Hung
- Office of Physical Education, National Chin-Yi University of Technology, Taichung, Taiwan
| | - Wen-Ling Yeh
- Department of Orthopaedic Surgery, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * Correspondence: Wen-Ling Yeh, Department of Orthopaedic Surgery, Lotung Poh-Ai Hospital, No. 81, Nanchang St., Luodong Township, Yilan County 265501, Taiwan (e-mail: )
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Hirohata K, Aizawa J, Ohmi T, Ohji S, Mitomo S, Ohara T, Koga H, Yagishita K, Jinno T, Okawa A. Reactive strength index during single-limb vertical continuous jumps after anterior cruciate ligament reconstruction: cross-sectional study. BMC Sports Sci Med Rehabil 2022; 14:150. [PMID: 35918729 PMCID: PMC9344617 DOI: 10.1186/s13102-022-00542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The association of the reactive strength index (RSI) during single-limb vertical continuous jumps (SVCJs) with single-limb hop tests in athletes after anterior cruciate ligament reconstruction (ACLR) is unclear. Thus, this study aimed to confirm the measurement properties of the RSI during SVCJs in athletes with ACLR at the phase of determining the timing of their return to sport. METHODS RSI during SVCJs and single-limb hop (single, triple, and crossover) tests were measured for post-ACLR and healthy athletes. The limb symmetry index (LSI) was calculated using the measurements of each parameter. For each test, patients were divided into two subgroups according to their LSI score (≥ 90%, satisfactory; < 90%, unsatisfactory). Fisher's exact test was used to examine the association of single-limb hop tests with RSI during the SVCJs. RESULTS A total of 21 post-ACLR and 17 healthy athletes completed all the tests. RSI during SVCJs was significantly lower on the involved limb than on the uninvolved limb in post-ACLR athletes (P < 0.001). The LSI of RSI during SVCJs of post-ACLR athletes was significantly lower than that of the healthy athletes (P < 0.01). Among the post-ACLR athletes, < 30% of those with LSIs > 90% in the single-limb hop tests had an LSI > 90% of the RSI during SVCJs. CONCLUSIONS RSI during SVCJs of post-ACLR athletes was significantly lower on the involved limb than on the uninvolved limb, and the asymmetry was more remarkable in the SVCJs than in the single-limb hop tests.
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Affiliation(s)
- Kenji Hirohata
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Junya Aizawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.,Department of Rehabilitation Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takehiro Ohmi
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Shunsuke Ohji
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Sho Mitomo
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Toshiyuki Ohara
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuyoshi Yagishita
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Atsushi Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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11
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Berg B, Urhausen AP, Øiestad BE, Whittaker JL, Culvenor AG, Roos EM, Crossley KM, Juhl CB, Risberg MA. What tests should be used to assess functional performance in youth and young adults following anterior cruciate ligament or meniscal injury? A systematic review of measurement properties for the OPTIKNEE consensus. Br J Sports Med 2022; 56:1454-1464. [PMID: 35697502 DOI: 10.1136/bjsports-2022-105510] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To critically appraise and summarise measurement properties of functional performance tests in individuals following anterior cruciate ligament (ACL) or meniscal injury. DESIGN Systematic review. DATA SOURCES Systematic searches were performed in Medline (Ovid), Embase (Ovid), CINAHL (EBSCO) and SPORTSDiscus (EBSCO) on 7 July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies evaluating at least one measurement property of a functional performance test including individuals following an ACL tear or meniscal injury with a mean injury age of ≤30 years. The COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias checklist was used to assess methodological quality. A modified Grading of Recommendations Assessment, Development and Evaluation assessed evidence quality. RESULTS Thirty studies evaluating 26 functional performance tests following ACL injury were included. No studies were found in individuals with an isolated meniscal injury. Included studies evaluated reliability (n=5), measurement error (n=3), construct validity (n=26), structural validity (n=1) and responsiveness (n=1). The Single Leg Hop and Crossover Hop tests showed sufficient intrarater reliability (high and moderate quality evidence, respectively), construct validity (low-quality and moderate-quality evidence, respectively) and responsiveness (low-quality evidence). CONCLUSION Frequently used functional performance tests for individuals with ACL or meniscal injury lack evidence supporting their measurement properties. The Single Leg Hop and Crossover Hop are currently the most promising tests following ACL injury. High-quality studies are required to facilitate stronger recommendations of performance-based outcomes following ACL or meniscal injury.
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Affiliation(s)
- Bjørnar Berg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Centre for Intelligent Musculoskeletal Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anouk P Urhausen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Centre, Vancouver, Vancouver, Canada
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Bundoora, Victoria, Australia
| | - Ewa M Roos
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Bundoora, Victoria, Australia
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Kobenhavn, Denmark
| | - May Arna Risberg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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12
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Read PJ, Pedley JS, Eirug I, Sideris V, Oliver JL. Impaired Stretch-Shortening Cycle Function Persists Despite Improvements in Reactive Strength After Anterior Cruciate Ligament Reconstruction. J Strength Cond Res 2022; 36:1238-1244. [PMID: 35482544 DOI: 10.1519/jsc.0000000000004208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Read, PJ, Pedley, JS, Eirug, I, Sideris, V, and Oliver, JL. Impaired stretch-shortening cycle function persists despite improvements in reactive strength followingafter anterior cruciate ligament reconstruction. J Strength Cond Res 36(5): 1238-1244, 2022-Reactive strength index (RSI) during a single-leg drop jump (SLDJ) has been indicated to determine return-to-sport readiness after anterior cruciate ligament (ACL) reconstruction, but only cross-sectional studies are available. Ground reaction force data and characterization of stretch-shortening cycle (SSC) function also remain sparse. Single-leg drop jump performance, ground reaction force, and SSC function were examined in soccer players with ACL reconstruction (n = 26) and matched controls (n = 25). Injured players were tested at 2 time points (32 and 42 weeks postsurgery). Stretch-shortening cycle function was classified as good (no impact peak and spring like), moderate (impact peak but still spring like or no impact peak and not spring like), or poor (impact peak and not spring like). The involved limb displayed lower-jump height, poorer RSI, less spring-like behavior, earlier peak landing force, and a greater ratio of landing peak to take-off peak force compared with the uninvolved limb and controls at the initial assessment (p < 0.001). Proportionally, more involved limbs were categorized as poor or moderate at the initial assessment (69.2%) and follow-up (50%) in comparison with the control limbs (14%). The reactive strength index was the only variable to change significantly between the initial assessment and follow-up on the involved limb (p < 0.05). No changes in the proportion of ACL reconstructed individuals categorized as poor or moderate SSC function at the follow-up assessment were observed. Residual deficits are present in SLDJ performance, SSC function, and ground reaction force characteristics after ACL reconstruction. The reactive strength index should not be the sole metric, as observed increases did not correspond with changes in SSC function.
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Affiliation(s)
- Paul J Read
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Institute of Sport Exercise and Health, London, United Kingdom
- Division of Surgery & Interventional Science, University College London, London, United Kingdom
- School of Sport and Exercise, University of Gloucestershire, Gloucester, United Kingdom
| | - Jason S Pedley
- Youth Physical Development Center, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom ; and
| | - Ifan Eirug
- Youth Physical Development Center, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom ; and
| | | | - Jon L Oliver
- Youth Physical Development Center, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom ; and
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
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13
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Jarvis P, Turner A, Read P, Bishop C. Reactive Strength Index and its Associations with Measures of Physical and Sports Performance: A Systematic Review with Meta-Analysis. Sports Med 2021; 52:301-330. [PMID: 34606061 DOI: 10.1007/s40279-021-01566-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Reactive strength index (RSI) is used frequently in the testing and monitoring of athletes. Associations with sports performance measures may vary dependent on the task but a literature synthesis has not been performed. OBJECTIVES The aim of this meta-analysis was to examine associations between RSI measured during rebound jumping tasks and measures of strength, linear and change of direction speed, and endurance performance. METHODS A systematic literature search with meta-analysis was conducted using databases PubMed, SPORTDiscus, Web of Science, and Ovid. Inclusion criteria required studies to (1) examine the relationship between RSI and an independent measure of physical or sporting performance for at least one variable; and (2) provide rebound test instructions to minimise ground contact time and maximise displacement of the jump. Methodological quality was assessed using a modified version of the Downs and Black Quality Index tool. Heterogeneity was examined via the Q statistic and I2. Pooled effect sizes were calculated using a random-effects model, with Egger's regression test used to assess small study bias (inclusive of publication bias). RESULTS Of the 1320 citations reviewed, a total of 32 studies were included in this meta-analysis. RSI was significantly and moderately associated with strength (isometric: r = 0.356 [95% CI 0.209-0.504]; isotonic: r = 0.365 [0.075-0.654]; pooled strength measures: r = 0.339 [0.209-0.469]) and endurance performance (r = 0.401 [0.173-0.629]). Significant moderate and negative associations were indicated for acceleration (r = - 0.426 [- 0.562 to - 0.290]), top speed (r = - 0.326 [- 0.502 to - 0.151]), and significant large negative associations were noted for change of direction speed (r = - 0.565 [- 0.726 to - 0.404]). Heterogeneity was trivial to moderate across all measures (I2 = 0-66%), and significant for isotonic strength and change of direction speed (p < 0.1). Evidence of small study bias was apparent for both acceleration and change of direction speed (p < 0.05). CONCLUSIONS We identified primarily moderate associations between RSI and independent measures of physical and sporting performance, and the strength of these relationships varied based on the task and physical quality assessed. The findings from this meta-analysis can help practitioners to develop more targeted testing and monitoring processes. Future research may wish to examine if associations are stronger in tasks that display greater specificity.
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Affiliation(s)
- Paul Jarvis
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, UK.
| | - Anthony Turner
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, UK
| | - Paul Read
- Institute of Sport, Exercise and Health, London, UK.,Division of Surgery and Interventional Science, University College London, London, UK.,School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Chris Bishop
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, UK
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14
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Kinetic measurement system use in individuals following anterior cruciate ligament reconstruction: a scoping review of methodological approaches. J Exp Orthop 2021; 8:81. [PMID: 34568996 PMCID: PMC8473525 DOI: 10.1186/s40634-021-00397-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/27/2021] [Indexed: 12/31/2022] Open
Abstract
Purpose Our primary objectives were to (1) describe current approaches for kinetic measurements in individuals following anterior cruciate ligament reconstruction (ACLR) and (2) suggest considerations for methodological reporting. Secondarily, we explored the relationship between kinetic measurement system findings and patient-reported outcome measures (PROMs). Methods We followed the PRISMA extension for scoping reviews and Arksey and O’Malley’s 6-stage framework. Seven electronic databases were systematically searched from inception to June 2020. Original research papers reporting parameters measured by kinetic measurement systems in individuals at least 6-months post primary ACLR were included. Results In 158 included studies, 7 kinetic measurement systems (force plates, balance platforms, pressure mats, force-measuring treadmills, Wii balance boards, contact mats connected to jump systems, and single-sensor insoles) were identified 4 main movement categories (landing/jumping, standing balance, gait, and other functional tasks). Substantial heterogeneity was noted in the methods used and outcomes assessed; this review highlighted common methodological reporting gaps for essential items related to movement tasks, kinetic system features, justification and operationalization of selected outcome parameters, participant preparation, and testing protocol details. Accordingly, we suggest considerations for methodological reporting in future research. Only 6 studies included PROMs with inconsistency in the reported parameters and/or PROMs. Conclusion Clear and accurate reporting is vital to facilitate cross-study comparisons and improve the clinical application of kinetic measurement systems after ACLR. Based on the current evidence, we suggest methodological considerations to guide reporting in future research. Future studies are needed to examine potential correlations between kinetic parameters and PROMs. Supplementary Information The online version contains supplementary material available at 10.1186/s40634-021-00397-0.
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15
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Davies WT, Myer GD, Read PJ. Is It Time We Better Understood the Tests We are Using for Return to Sport Decision Making Following ACL Reconstruction? A Critical Review of the Hop Tests. Sports Med 2021; 50:485-495. [PMID: 31745732 PMCID: PMC7018781 DOI: 10.1007/s40279-019-01221-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
There has been a move towards a criterion-based return to play in recent years, with 4 single-leg hop tests commonly used to assess functional performance. Despite their widespread integration, research indicates that relationships between ‘passing’ ‘hop test criteria and successful outcomes following rehabilitation are equivocal, and, therefore, require further investigation. This critical review includes key information to examine the evolution of these tests, their reliability, relationships with other constructs, and sensitivity to change over time. Recommendations for how measurement and administration of the tests can be improved are also discussed. The evidence presented in this review shows that hop tests display good reliability and are sensitive to change over time. However, the use of more than 2 hop tests does not appear to be necessary due to high collinearity and no greater sensitivity to detect abnormality. The inclusion of other hop tests in different planes may give greater information about the current function of the knee, particularly when measured over time using both relative and absolute measures of performance. It is recommended that the contralateral limb be tested prior to surgery for a more relevant benchmark for performance, and clinicians are strongly advised to measure movement quality, as hop distance alone appears to overestimate the recovery of the knee.
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Affiliation(s)
- William T Davies
- Aspetar, Orthopaedic and Sports Medicine Hospital, Sports City Street, P.O. Box 29222, Doha, Qatar.
| | - Gregory D Myer
- Division of Sports Medicine, The SPORT Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Departments of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
| | - Paul J Read
- Aspetar, Orthopaedic and Sports Medicine Hospital, Sports City Street, P.O. Box 29222, Doha, Qatar
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16
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Relationships between physical capacities and biomechanical variables during movement tasks in athletic populations following anterior cruciate ligament reconstruction. Phys Ther Sport 2021; 48:209-218. [PMID: 33529930 DOI: 10.1016/j.ptsp.2021.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Anterior cruciate ligament (ACL) reconstruction has a detrimental impact on athletic performance. Despite rehabilitation guidelines and criterion-based progressions to ensure safe restoration of fundamental physical capacities and maladaptive movement strategies, residual deficits in maximal strength, rate of force development (RFD), power and reactive strength are commonly reported. These combined with associated compensatory inter and intra-limb strategies increase the risk of re-injury. OBJECTIVE The aim of this article is to examine the relationships between fundamental physical capacities and biomechanical variables during dynamic movement tasks. DESIGN Narrative review. RESULTS The available data suggests that quadriceps strength and rate of torque development, explain a moderate portion of the variance in aberrant kinetic and kinematic strategies commonly detected in ACL reconstructed cohorts in the later stages of rehabilitation and RTS CONCLUSION: The available data suggests that quadriceps strength and rate of torque development, explain a moderate portion of the variance in aberrant kinetic and kinematic strategies commonly detected in ACL reconstructed cohorts in the later stages of rehabilitation and RTS.
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17
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Strength, rate of force development, power and reactive strength in adult male athletic populations post anterior cruciate ligament reconstruction - A systematic review and meta-analysis. Phys Ther Sport 2021; 47:91-104. [DOI: 10.1016/j.ptsp.2020.11.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 12/26/2022]
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18
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Troy Blackburn J, Dewig DR, Johnston CD. Time course of the effects of vibration on quadriceps function in individuals with anterior cruciate ligament reconstruction. J Electromyogr Kinesiol 2020; 56:102508. [PMID: 33302006 DOI: 10.1016/j.jelekin.2020.102508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/16/2020] [Accepted: 11/23/2020] [Indexed: 11/18/2022] Open
Abstract
Quadriceps dysfunction is a common, chronic complication following anterior cruciate ligament reconstruction (ACLR) that contributes to aberrant gait biomechanics and poor joint health. Vibration enhances quadriceps function in individuals with ACLR, but the duration of these effects is unknown. This study evaluated the time course of the effects of whole body vibration (WBV) and local muscle vibration (LMV) on quadriceps function. Twenty-four volunteers with ACLR completed 3 testing sessions during which quadriceps isometric peak torque, rate of torque development, and EMG amplitude were assessed prior to and immediately, 10, 20, 30, 45, and 60 min following a WBV, LMV, or control intervention. WBV and LMV (30 Hz, 2g) were applied during six one-minute bouts. WBV increased peak torque 5-11% relative to baseline and control at all post-intervention time points. LMV increased peak torque 6% relative to baseline at 10 min post-intervention and 4-6% relative to control immediately, 10 min, and 20 min post-intervention. The interventions did not influence EMG amplitudes or rate of torque development. The sustained improvements in quadriceps following vibration, especially WBV, suggest that it could be applied at the beginning of rehabilitation sessions to "prime" the central nervous system, potentially improving the efficacy of ACLR rehabilitative exercise.
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Affiliation(s)
- J Troy Blackburn
- Department of Exercise and Sport Science, High Point University, USA; Program in Human Movement Science, High Point University, USA.
| | - Derek R Dewig
- Program in Human Movement Science, High Point University, USA
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19
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Rambaud AJM, Rossi J, Neri T, Samozino P, Edouard P. Evolution of Functional Recovery using Hop Test Assessment after ACL Reconstruction. Int J Sports Med 2020; 41:696-704. [PMID: 32396964 DOI: 10.1055/a-1122-8995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to evaluate improvements in functional performance through the use of the Limb Symmetry Index of Single and Triple Hop tests between 12 and 52 weeks after anterior cruciate ligament reconstruction, and to compare these values with usual time-based and performance-based criteria used during the return to sport continuum. Repeated functional assessments using Single and Triple Hop Tests at 12, 16, 22, 26, 39 and 52 postoperative weeks were evaluated. At each session, the median and interquartile range of Limb Symmetry Index of tests were calculated and compared with the usual criteria: return to participation:≥85%, between 12-16 w; return to play:≥90%, between 26-39 w. The results indicate that the median increased over time to 39 postoperative weeks and then stabilized. For Single Hop Test, wide variability was seen at 12 and 16 weeks (interquartile range=20%); this was lower from 22 to 52 weeks (interquartile range=8-6%). At 12 weeks for Single Hop Test, the median was 83.6% and did not meet>85% criteria for return to participation. Hop tests could be interesting functional tests to follow the functional recovery and help decision-making regarding return to participation and return to play.
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Affiliation(s)
- Alexandre J M Rambaud
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023 Saint-Etienne, France.,SFMKS-Lab, SFMKS, Pierrefitte/Seine, France
| | - Jérémy Rossi
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023 Saint-Etienne, France
| | - Thomas Neri
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023 Saint-Etienne, France.,Department of Orthopedic Surgery, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pierre Samozino
- Univ Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-73000 Chambéry, France
| | - Pascal Edouard
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023 Saint-Etienne, France.,Department of Exercise and clinical Physiology -Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
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20
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Patterson BE, Crossley KM, Perraton LG, Kumar AS, King MG, Heerey JJ, Barton CJ, Culvenor AG. Limb symmetry index on a functional test battery improves between one and five years after anterior cruciate ligament reconstruction, primarily due to worsening contralateral limb function. Phys Ther Sport 2020; 44:67-74. [PMID: 32447259 DOI: 10.1016/j.ptsp.2020.04.031] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/14/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Evaluate change in functional performance from 1- to 5-years after anterior cruciate ligament reconstruction (ACLR). METHODS 59 participants (38 men) aged 29 ± 16 years completed three hops and one-leg rise 1- and 5-years following ACLR. Linear mixed-effects models evaluated differences in change between the ACLR and contralateral limbs. Participants were classified with stable, improving or worsening function relative to previously published minimal detectable change thresholds. Healthy controls completed the three hops (n = 41) and one-leg rise (n = 31) as reference data. RESULTS The contralateral limb had a significantly greater decrease in functional performance between 1- and 5-years for the three hops, compared to the ACLR limb. Worsening was more common in the contralateral limb than the ACLR limb; resulting in significant improvements in the LSI for the single hop (mean 87% at 1-year to 95% at 5-years), side hop (77%to 86%) and one-leg rise (76% to85%). Performance of both ACLR and contralateral limbs and the LSI remained below the healthy controls. CONCLUSION Functional performance changes differ between limbs between 1- and 5-years post-ACLR. The LSI should not be used in isolation to evaluate functional performance changes after ACLR, as it may overestimate functional improvement, due to worsening contralateral limb function.
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Affiliation(s)
- Brooke E Patterson
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Luke G Perraton
- Department of Physiotherapy, School of Primary Health Care, Monash University, Frankston, Australia
| | - Avnish S Kumar
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Joshua J Heerey
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia.
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21
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No shortage of disagreement between biomechanical and clinical hop symmetry after anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon) 2019; 68:144-150. [PMID: 31212209 DOI: 10.1016/j.clinbiomech.2019.05.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/04/2019] [Accepted: 05/28/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Evaluating average performance on functional hop tasks can potentially overestimate physical function, as it masks variability present within individual trials and may lead to clinician oversight regarding the overall movement quality. The purpose was to evaluate the trial-by-trial agreement between hop-distance symmetry and knee biomechanics (knee flexion angle, knee extension moment) to reveal the full extent of agreement between these measures. METHODS Sixteen individuals with primary, unilateral anterior cruciate ligament reconstruction participated (age: 22(2) y; height: 1.71(0.11) m; mass: 68.94(13.06) kg; gender: 8 males, 8 females; years' post-surgery:4(3) y) in a cross-sectional study. Knee kinematics and kinetics were measured using 3D motion analysis and hop distance was collected during the triple hop for distance. Individual limb difference values for individual hop trials were calculated and values for each trial were dichotomized as pass/fail based on achieving a limb difference of <10%. Cohen's Kappa and confirmatory McNemar's test were performed to determine the level of agreement between measures of physical and biomechanical function between trials. FINDINGS No agreement between triple hop and peak knee flexion angle symmetry (κ = 0.033, p = 0.387) and peak internal knee extension moment (κ = 0.022, p = 0.475) were found. McNemar tests confirmed no agreement between hop-distance %LD and knee flexion angle/knee extension moment %LD (p = 0.000). INTERPRETATION These findings suggest that while individuals after ACLR may on average achieve symmetrical hop-distance, they may not necessarily pass subsequent functional tasks. Further, individual trial-by-trial analyses may provide insight into an individual's true physical capability compared to simply evaluating the average, which may overestimate physical function or mask altered movement strategies.
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