Title | Clinical Predictors of Knee Mechanics at Return to Sport after ACL Reconstruction. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Kline PW, Johnson DL, Ireland MLloyd, Noehren B |
Journal | Med Sci Sports Exerc |
Volume | 48 |
Issue | 5 |
Pagination | 790-5 |
Date Published | 2016 May |
ISSN | 1530-0315 |
Keywords | Adolescent, Adult, Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Reconstruction, Athletes, Biomechanical Phenomena, Exercise Test, Female, Humans, Knee Joint, Male, Muscle Strength, Quadriceps Muscle, Return to Sport, Young Adult |
Abstract | PURPOSE: Despite significant rehabilitation, many athletes experience protracted weakness and faulty mechanics after anterior cruciate ligament reconstruction (ACLR). Clinical tests performed early in rehabilitation, which predict knee mechanics at return-to-sport, are virtually unknown and critically needed to guide clinical decision making. The purpose of this study is to determine if quadriceps strength, Y balance anterior (YB-A) reach distance, and single-leg step-down test performance (SLSD) conducted 3 months post-ACLR are predictive of knee flexion excursion (KFLEX) and knee extensor moment (KEM) during running 6 months post-ACLR. METHODS: Thirty (16 females) subjects were collected 3 and 6 months post-ACLR. Age, 21.3 ± 7.6 yr; mass, 69.85 ± 11.4 kg; height, 1.73 ± 0.09 m. At 3 months post-ACLR, subjects performed isometric quadriceps strength testing, YB-A, and SLSD assessments. At 6 months post-ACLR, subjects underwent three-dimensional motion analysis while running on an instrumented treadmill. Pearson correlation coefficients and stepwise multiple regression were used to assess the relationships of 3-month and 6-month variables. RESULTS: Quadriceps strength (r = 0.493, P < 0.01), YB-A (r = 0.394, P = 0.03), and SLSD (r = 0.648, P < 0.01) were significantly correlated to KFLEX. Quadriceps strength (0.505, P < 0.01) and SLSD (.541, P < 0.01) were significantly correlated with KEM, whereas YB-A (.276, P = 0.06) was not. SLSD and quadriceps strength were predictive of KEM (adj R², 0.36; P = 0.001) whereas only SLSD was predictive of KFLEX (adj R², 0.40; P < 0.001). CONCLUSIONS: After ACLR, better performance in SLSD and quadriceps strength 3 months postsurgery is predictive of improved sagittal plane knee mechanics during running 6 months postsurgery. |
DOI | 10.1249/MSS.0000000000000856 |
Alternate Journal | Med Sci Sports Exerc |
PubMed ID | 26694845 |
PubMed Central ID | PMC5189680 |
Grant List | UL1 TR000117 / TR / NCATS NIH HHS / United States TL1 TR000115 / TR / NCATS NIH HHS / United States UL1 RR033173 / RR / NCRR NIH HHS / United States K23 AR062069 / AR / NIAMS NIH HHS / United States K23AR062069 / AR / NIAMS NIH HHS / United States TL1TR00015 / TR / NCATS NIH HHS / United States TL1 TR001997 / TR / NCATS NIH HHS / United States |